Palmer A J, Beevers D G, Bulpitt C J, Butler A, Coles E C, Conway J, Fletcher A E, Ledingham J G, Nicholls A, O'Riordan P W
Hammersmith Hospital, London, UK.
J Hypertens. 1990 Jun;8(6):521-4. doi: 10.1097/00004872-199006000-00004.
In 1986, the Committee on Safety of Medicines published a report suggesting that enalapril may have an adverse effect on renal function. The prescription event monitoring scheme subsequently published figures on adverse drug reactions and mortality for patients treated with enalapril. They concluded that enalapril did not have an adverse effect on renal function and survival. Similar data were not available for captopril, as the drug was marketed before prescription event monitoring had been developed. In the Department of Health and Social Security (DHSS) Hypertension Care Computing Project (DHCCP), 368 hypertensive patients treated with captopril and 371 treated with enalapril were followed for an average of 3.1 and 1.6 years, respectively. Thirty-two patients died; none had renal failure as an underlying cause of death. The death rate was similar in both drug groups, at 17.5 (enalapril) and 24.0 (captopril) per 1000 patient-years. The present report shows that, for patients treated for high blood pressure, the relative risk of mortality with captopril compared with enalapril was 1.37, an insignificant difference (95% confidence interval 0.63, 2.98).
1986年，药品安全委员会发表了一份报告，指出依那普利可能对肾功能产生不良影响。处方事件监测计划随后公布了使用依那普利治疗的患者的药物不良反应和死亡率数据。他们得出结论，依那普利对肾功能和生存率没有不良影响。由于卡托普利在处方事件监测开展之前就已上市，因此没有类似的数据。在卫生与社会保障部（DHSS）的高血压护理计算机项目（DHCCP）中，分别对368例接受卡托普利治疗的高血压患者和371例接受依那普利治疗的高血压患者进行了平均3.1年和1.6年的随访。32例患者死亡；均无肾衰竭作为潜在死因。两个药物组的死亡率相似，依那普利组为每1000患者年17.5例，卡托普利组为每1000患者年24.0例。本报告表明，对于高血压患者，与依那普利相比，卡托普利的相对死亡风险为1.37，差异无统计学意义（95%置信区间0.63, 2.98）。
