A double-blind study to compare the efficacy, tolerance and safety of two doses of the angiotensin converting enzyme inhibitor ramipril with placebo

Villamil, Alberto S.; Cairns, Victoria; Witte, Peter Uwe; Bertolasi, Carlos A.

doi:10.1016/0002-9149(87)90064-6

Cited by 11 publications

(3 citation statements)

References 4 publications

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“…Heber and colleagues [4] used intra-arterial ABP monitoring to confirm a 24 h duration of antihypertensive effect following optimised steady state dosing with ramipril (minimum dose 10 mg). Using clinic blood pressure Villamil et al [20] suggested that the minimum effective dose of ramipril was 5 mg daily. In contrast, the present study found a significant reduction in mean 24 h diastolic ABP following monotherapy with 2.5 mg ramipril.…”

Section: Discussionmentioning

confidence: 99%

The antihypertensive efficacy and tolerability of a low dose combination of ramipril and felodipine ER in mild to moderate essential hypertension

Bainbridge

Stark

et al. 1993

Brit J Clinical Pharma

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The antihypertensive efficacy and tolerability of a low dose combination of the angiotensin converting enzyme inhibitor ramipril (2.5 mg) and the extended release formulation of the dihydropyridine calcium channel antagonist felodipine (5 mg) were assessed in a double‐blind, double dummy placebo controlled, randomised, crossover study in 20 patients (mean age 55.4 years; range 46–69) with uncomplicated mild to moderate hypertension (supine diastolic >90 mmHg <115 mmHg after 4 weeks of single‐blind wash‐out on placebo). The four randomised, double‐blind, crossover study phases evaluated the response to 4 weeks of once daily treatment with placebo, monotherapy with each drug and the combination. Noninvasive ambulatory blood pressure monitoring (Spacelabs 90207) was performed for 24 h at the end of each phase. The mean 24 h ambulatory blood pressure (mmHg) was 147.9/92.0 following placebo, 141.3/87.8 following monotherapy with ramipril 2.5 mg, 136.8/85.8 following monotherapy with felodipine ER 5 mg and 131.1/82.6 following the combination of ramipril 2.5 mg and felodipine ER 5 mg. All active treatment phases significantly reduced mean 24 h ambulatory diastolic pressure by comparison with placebo. The antihypertensive efficacy of the combination was additive. The coadministration of ramipril did not attenuate the incidence of headache attributable to felodipine ER.

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Section: Discussionmentioning

confidence: 99%

The antihypertensive efficacy and tolerability of a low dose combination of ramipril and felodipine ER in mild to moderate essential hypertension

Bainbridge

Stark

et al. 1993

Brit J Clinical Pharma

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“…We examined the effect of two long acting, potent angiotensin converting enzyme inhibitors, enalapril and ramipril (ramipril is currently undergoing phase II and phase III clinical evaluation for treating heart failure and hypertension'3 14), on blood pressure, plasma angiotensin converting enzyme activity, and cough in a double blind crossover study.…”

Section: Introductionmentioning

confidence: 99%

Change in cough reflex after treatment with enalapril and ramipril.

McEwan¹,

Choudry²,

Street³

et al. 1989

BMJ

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Objective-To find out whether enalapril or ramipril causes the sensitivity of the cough reflex to change or symptomatic cough to develop in patients with hypertension.Design-Prospective, placebo controlled, double blind, randomised crossover study.Setting-Academic units of clinical pharmacology and medicine.Patients-20 Patients (nine men and 11 women) who needed to take angiotensin converting enzyme inhibitors to control hypertension.Interventions-All patients received enalapril 10 mg daily, ramipril 10 mg daily, or placebo daily for one week in random order, with a washout period of at least one week between treatments. For assessment of sensitivity of the cough reflex the patients inhaled various concentrations of capsaicin solution in random order.Main outcome measures-Measurement of the doses of capsaicin required to cause two or more and five or more coughs or the development of a symptomatic cough.Results-Blood pressure, symptoms of cough, and the sensitivity of the cough reflex to inhaled capsaicin were recorded at the start of the study and before and at the end of each treatment period. Plasma urea and creatinine concentrations and angiotensin converting enzyme activity were measured at the start of the study and the end of each treatment period. Data were analysed by two way analysis ofvariance. Mean blood pressure was 159/97 mm Hg at the start of the study and 152/92, 143/88, and 147/86 mm Hg after treatment with placebo, enalapril, and ramipril respectively. Mean (SE) plasma angiotensin converting enzyme activity was 2-2 (0-2) mmol/l/h after treatment with placebo and fell significantly to 1-3 (0-1) mmolll/h and to 0-4 (0

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“…Angiotensin converting enzyme (ACE) inhibitors have been shown to be effective and safe in the treatment of hypertensive patients; 2–5 in long‐term studies they have also been shown to induce regression of left ventricular hypertrophy 6–8 . Ramipril, like enalapril, is a non‐sulfhydryl ACE‐inhibitor which has been widely investigated in the treatment of essential hypertension, 7 , 9–27 congestive heart failure (CHF), 28–37 as well as CHF developing after myocardial infarction 18–40 . Because of its pentane ring, ramiprilat (the active moiety) is at least 23 times more lipophilic than enalaprilat.…”

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confidence: 99%

Efficacy of Ramipril Versus Enalapril in Patients With Mild to Moderate Essential Hypertension

Yasky

Verho²,

Erasmus

et al. 1996

Int J Clinical Practice

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SUMMARY This double‐blind, randomised, cross‐over study investigated the antihypertensive efficacy of ramipril and enalapril was completed by 30 patients with mild‐to‐moderate essential hypertension. After a four‐week placebo run‐in phase, the patients received either 2.5mg ramipril or 10mg enalapril once daily for four weeks. The dosages were increased to 5mg ramipril and 20mg enalapril for a further four weeks. After a placebo washout phase of four weeks, the patients were crossed over to the alternative treatment. The decrease in average 24‐hour ambulatory diastolic blood pressure from week 0 to week 8 was 1.6mmHg greater with ramipril than enalapril (90% confidence interval 0.6‐2.7mmHg). The corresponding reduction in for systolic blood pressure was also greater with ramipril than enalapril by 2.4mmHg (90% confidence interval: 0.5‐4.2mmHg). For the difference in the drop of 24‐hour ambulatory diastolic blood pressure between ramipril and enalapril the lower level of the 90% confidence interval (CI) is above the clinically relevant difference of ‐3mmHg. This is an indication that ramipril (2.5 and 5mg dose) is at least as effective as enalapril (10 and 20mg dose) in decreasing blood pressure in patients with mild‐to‐moderate essential hypertension. The duration of adequate antihypertensive effect was relatively long for both ramipril and enalapril; however, ramipril tended to have a more prolonged antihypertensive effect. Ramipril had a higher diastolic and systolic trough/peak ratio than enalapril, resulting in a more uniform antihypertensive effect over the 24‐hour treatment period. Both ramipril and enalapril were well tolerated and the two treatment groups had similar safety profiles.

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A double-blind study to compare the efficacy, tolerance and safety of two doses of the angiotensin converting enzyme inhibitor ramipril with placebo

Cited by 11 publications

References 4 publications

The antihypertensive efficacy and tolerability of a low dose combination of ramipril and felodipine ER in mild to moderate essential hypertension

The antihypertensive efficacy and tolerability of a low dose combination of ramipril and felodipine ER in mild to moderate essential hypertension

Change in cough reflex after treatment with enalapril and ramipril.

Efficacy of Ramipril Versus Enalapril in Patients With Mild to Moderate Essential Hypertension

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