Evaluation of Antihypertensive Effectiveness and Influence on Arterial Stiffness of Ramipril (Ramizes), Administered as Monotherapy or in Combination with Amlodipine (Aladin), in Patients with Mild-to-Moderate Hypertension

A.D. Radchenko, Ye.A. Torbas, A.S. Dobrokhod, Yu.N. Sirenko, S.A. Polischuk

Abstract


The aim of study was to evaluate of antihypertensive effectiveness and influence on arterial stiffness of ramipril (Ramizes manufactured by Farmak JSC, Ukraine) as monotherapy or in combination with amlodipine (Aladin by by Farmak JSC, Ukraine) on central blood pressure (BP) and pulse ware velocity (PWVe) in elastic and muscular arteries (PWVm) in patients with mild-to-moderate arterial hypertension (AH).
There were included 37 patients with mild-to-moderate AH (mean age — 53.40 ± 2.35 years). All patients at baseline and at the stages of observation conducted studies : measurement of weight and height, the measurement of office systolic BP (SBP), diastolic (DBP), heart rate, 24-hour BP monitoring, identification and PWVe and PWVm, central BP, biochemical blood analysis, ECG. After randomization, patients were administered ramipril 10 mg/day. If BP level in 1 month was higher than the target one, then added amlodipine 5 mg/day, the dose of which was increased to 10 mg for treatment failure on the 2nd month of treatment. The duration of therapy was 3 months.
According to the office BP measurement, three-month treatment effectively reduced the office SBP/DBP from
152.7 ± 3.6/92.7 ± 2.2 mmHg to 133.0 ± 1.9/80.9 ± 1.6 mmHg. The target office BP level was achieved in 21 (56.8 %) patients on montherapy and in 36 (97.3 %) on combination therapy. The mean lowering of daily average SBP/DBP was 14.1 ± 0.9/5.1 ± 0.2 mmHg, dSBP/dDBP — 14.8 ± 0.4/
7.4 ± 0.3 mmHg and nSBP/nDBP — 11.5 ± 0.3/
3.2 ± 0.1 mmHg. The target daily average SBP and DBP were achieved in 17 (45.9 %) patients on monotherapy and in 29 (78.4 %) on combination ramipril + amlodipine. Positive antihypertensive effects were confirmed by significant reduction in variability of dSBP, maxSBP, maxDBP, time load and pressure indices 24SBP, dSBP, nSBP, 24DBP, dDBP and nDBP. Treatment was associated with a significant decrease of central SBP from 129.5 ± 2.2 mmHg to 118.5 ± 1.5 mmHg and improvment of for arteries of elastic type, that mainifested in recudtion of PWVe, PWVm and aortic index. Adverse reactions rate was 5.4 % (on combination — 2.7 %).


Keywords


antihypertensive efficacy; central blood pressure; arterial stiffness; ramipril

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DOI: https://doi.org/10.22141/2224-1485.5.31.2013.86461

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