Efficacy of Ramipril in Therapy-resistant Hypertension

Summary

In an open, 48-week study the antihypertensive efficacy of ramipril when administered as add-on therapy to existing triple antihypertensive treatment (diuretics, β-blockers, vasodilators) was investigated in 36 patients (24 females, 32 males) with therapy-resistant hypertension. The main variable (sitting diastolic blood pressure) decreased from 112 mm Hg at baseline to 91 mm Hg at week 8(p<0.01) and remained stable thereafter until the end of the trial. The systolic blood pressure in the sitting position decreased from 173 mmHg at baseline to 146 mm Hg at week 8 (p<0.01) and also remained stable thereafter until the end of the trial. Ramipril doses between week 8 and the end of the trial were not changed in 82% of patients. 43% of patients were treated with 5 mg ramipril/day, 33% with 10mg/day and 22% with 20mg/day at the end of the study. Addition of ramipril allowed a reduction in the doses of concurrent therapy, especially in relation to β-blockers (p<0.02) and vasodilators (p<0.01). The safety was good -no serious adverse events were observed. Ramipril is, therefore, a suitable drug for the patients with therapy-resistant hypertension allowing reduction of the doses of concomitant medication.

Key Words::

• Ramipril
• ACE inhibitors
• Hypertension
• Difficult-to-treat hypertension