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Large prospective study of ramipril in patients with hypertension. CARE Investigators
N M Kaplan1, L E Sproul, W S Mulcahy
1University of Texas Southwestern Medical School, Dallas.
Insights
This study shows that low-dose ramipril effectively lowers blood pressure in patients with essential hypertension. Once-daily ramipril treatment was well-tolerated and safe for most patients.
Area of Science:
- Cardiology
- Pharmacology
Background:
- Essential hypertension is a prevalent condition requiring effective and well-tolerated treatments.
- Ramipril is an angiotensin-converting enzyme (ACE) inhibitor known for its blood pressure-lowering effects.
Purpose of the Study:
- To evaluate the efficacy and safety of ramipril in a large, diverse patient population with essential hypertension.
- To assess the optimal dosage and tolerability of ramipril for once-daily administration.
Main Methods:
- A multicenter, open-label, prospective study involving 591 patients with essential hypertension.
- Patients received ramipril (1.25 to 10 mg) once daily for 8 weeks, with dosage adjusted as needed.
- Blood pressure measurements were taken at baseline and study completion.
Main Results:
- Ramipril significantly reduced mean systolic blood pressure by 19.9 mmHg and diastolic blood pressure by 14.7 mmHg (P < 0.001).
- 84.1% of patients achieved a diastolic blood pressure of <= 90 mmHg or a reduction of at least 10 mmHg.
- Low doses (<= 5 mg) were sufficient for most patients, and ramipril was well-tolerated with no adverse event-related discontinuations.
Conclusions:
- Once-daily, low-dose ramipril is an effective and safe treatment for essential hypertension in a broad patient population.
- Ramipril demonstrates a favorable safety profile and long duration of action, suitable for convenient once-daily dosing.
Abstract:
The results of controlled trials demonstrate that ramipril lowers blood pressure in hypertensive patients, has a long duration of action suitable for once-daily administration in most patients, and is well tolerated. To assess the efficacy and safety of ramipril in a large cross-section of patients, we conducted a multicenter, open-label, prospective study, in which 591 men or women with essential hypertension (diastolic blood pressure > or = 95 and < or = 114 mmHg) received ramipril on a regimen of 1.25 to 10 mg once daily for 8 weeks. Forty-one percent of the patients required 2.5 mg and 81% required < or = 5 mg once daily at study completion. Compared with baseline, ramipril reduced mean systolic/diastolic blood pressure by 19.9/14.7 mmHg (P < 0.001/P < 0.001). Ramipril reduced diastolic blood pressure to < or = 90 mmHg or by at least 10 mmHg in 84.1% of the patients. Response rates were similar regardless of age, gender, and race. No patient stopped ramipril because of an adverse event or experienced an unexpected adverse event. In our real-world study, low-dose ramipril given once daily controlled blood pressure in most patients and was well tolerated.