Abstract

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.