Perindopril improves six minute walking distance in older patients with left ventricular systolic dysfunction: a randomised double blind placebo controlled trial.
OBJECTIVE
To evaluate the effects of the angiotensin converting enzyme inhibitor perindopril on six minute walking distance and quality of life in very old patients with left ventricular systolic dysfunction.


DESIGN
Prospective, double blind placebo controlled trial.


SETTING
Medicine for the elderly day hospital.


PATIENTS
66 patients (average age 81) with left ventricular systolic dysfunction identified by echocardiography.


INTERVENTIONS
10 weeks of treatment with titrated doses of perindopril or placebo.


MAIN OUTCOME MEASURES
Six minute walking distance 10 weeks following treatment, quality of life measurements including the Minnesota living with heart failure questionnaire and the 36 item short form health survey.


RESULTS
In patients with left ventricular systolic dysfunction, six minute walking distance was significantly increased in the treatment group (37.1 m) compared with the placebo group (-0.3 m, p < 0.001). The medication was well tolerated and there were no significant adverse events.


CONCLUSIONS
Six minute walking distance is improved considerably by treatment with perindopril in older patients with heart failure caused by left ventricular systolic dysfunction.