ANTIHYPERTENSIVE EFFICACY AND SAFETY OF OLMESARTAN AND RAMIPRILIN ELDERLY PATIENTS WITH MILD TO MODERATE SYSTOLIC AND DIASTOLICESSENTIAL HYPERTENSION

Objective. To compare the efficacy and safety of olmesartan medoxomil (O) and ramipril (R) in elderly patients with essential arterial hypertension. Methods. After a 2‑week placebo washout, 351 elderly hypertensive patients aged 65–89 years (office sitting diastolic blood pressure, DBP, 90–109 mmHg...

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Main Authors: J‑M. Mallion, S. Omboni, J. Barton, W. van Mieghem, K. Narkiewicz, P‑K. Panzer, J. G. Puig, Ch. Stefanadis, R. Zwieker
Format: Article
Language:Russian
Published: «FIRMA «SILICEA» LLC 2012-06-01
Series:Российский кардиологический журнал
Subjects:
Online Access:https://russjcardiol.elpub.ru/jour/article/view/1232
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author J‑M. Mallion
S. Omboni
J. Barton
W. van Mieghem
K. Narkiewicz
P‑K. Panzer
J. G. Puig
Ch. Stefanadis
R. Zwieker
author_facet J‑M. Mallion
S. Omboni
J. Barton
W. van Mieghem
K. Narkiewicz
P‑K. Panzer
J. G. Puig
Ch. Stefanadis
R. Zwieker
author_sort J‑M. Mallion
collection DOAJ
description Objective. To compare the efficacy and safety of olmesartan medoxomil (O) and ramipril (R) in elderly patients with essential arterial hypertension. Methods. After a 2‑week placebo washout, 351 elderly hypertensive patients aged 65–89 years (office sitting diastolic blood pressure, DBP, 90–109 mmHg and office sitting systolic blood pressure, SBP, 140–179 mmHg) were randomized doubleblind to 12‑week treatment with O 10 mg or R 2.5 mg once daily. After the first 2 and 6 weeks, doses could be doubled in non-normalized (blood pressure ≥140/90 mmHg for non-diabetic and ≥ 130/80 mmHg for diabetic) subjects, up to 40 mg for O and 10 mg for R. Office blood pressures were assessed at randomization, after 2, 6 and 12 weeks of treatment; 24‑h ambulatory blood pressure (ABP) was recorded at randomization and after 12 weeks. Results. At week 12, in the intention-to-treat population (170 patients O and 175 R) the rate of normalized subjects was significantly larger in the O group (38.8% vs 26.3% R; p = 0.013). Baseline-adjusted mean sitting office blood pressure reduction at final visit was not significantly greater under O [SBP: 16.6 (95% confidence interval 14.0/19.2) mmHg vs 13.0 (10.4/15.6) mmHg R, p = 0.206; DBP: 11.8 (10.3/13.3) mmHg vs 10.5 (9.0/12.0) mmHg, p = 0.351]. In the subgroup of patients with valid ABP recordings (38 O and 47 R), the reduction in 24‑h average blood pressure was significantly (p = 0.01) larger with O [SBP: 8.9 (9.8/8.1) and DBP: 5.7 (6.3/5.1) mmHg] than with R [6.7 (7.9/5.6) and 4.4 (5.1/3.7) mmHg]. The superiority of O was particularly evident in the last 4 h from the dosing interval. The proportion of patients with drug-related adverse events was comparable in the two groups (4.0% O vs 4.5% R), as well as the number of patients discontinuing study drug because of a side-effect (8 O vs 7 R). Conclusions. In elderly patients with essential arterial hypertension, O provides an effective, prolonged and well tolerated blood pressure control, with significantly better blood pressure normalization than R and represents a useful option among first-line drug treatments of hypertension in this age group.
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spelling doaj.art-f01ba07a3c4b4546950606fdf21fa0d32023-03-29T21:23:19Zrus«FIRMA «SILICEA» LLCРоссийский кардиологический журнал1560-40712618-76202012-06-010374841034ANTIHYPERTENSIVE EFFICACY AND SAFETY OF OLMESARTAN AND RAMIPRILIN ELDERLY PATIENTS WITH MILD TO MODERATE SYSTOLIC AND DIASTOLICESSENTIAL HYPERTENSIONJ‑M. Mallion0S. Omboni1J. Barton2W. van Mieghem3K. Narkiewicz4P‑K. Panzer5J. G. Puig6Ch. Stefanadis7R. Zwieker8Cardiology and Arterial Hypertension, CHU de Grenoble, Grenoble, FranceItalian Institute of Telemedicine, Varese, ItalyCardiac Research Department, Portiuncula Hospital, Ballinasloe Co Galway, IrelandDienst Cardiologie, Ziekenhuis Oost Limburg Campus St. Jan, Genk, BelgiumDepartment of Hypertension and Diabetology Hypertension Unit, Medical University of Gdansk, Gdansk, PolandKippenheim, GermanyInternal Medicine and Hypertension Unit, Hospital Universitario de La Paz, Madrid, SpainDepartment of Cardiology, Ippokratio Hospital, Athens, GreeceLeopold Auenbrugger University Medical School, Graz, AustriaObjective. To compare the efficacy and safety of olmesartan medoxomil (O) and ramipril (R) in elderly patients with essential arterial hypertension. Methods. After a 2‑week placebo washout, 351 elderly hypertensive patients aged 65–89 years (office sitting diastolic blood pressure, DBP, 90–109 mmHg and office sitting systolic blood pressure, SBP, 140–179 mmHg) were randomized doubleblind to 12‑week treatment with O 10 mg or R 2.5 mg once daily. After the first 2 and 6 weeks, doses could be doubled in non-normalized (blood pressure ≥140/90 mmHg for non-diabetic and ≥ 130/80 mmHg for diabetic) subjects, up to 40 mg for O and 10 mg for R. Office blood pressures were assessed at randomization, after 2, 6 and 12 weeks of treatment; 24‑h ambulatory blood pressure (ABP) was recorded at randomization and after 12 weeks. Results. At week 12, in the intention-to-treat population (170 patients O and 175 R) the rate of normalized subjects was significantly larger in the O group (38.8% vs 26.3% R; p = 0.013). Baseline-adjusted mean sitting office blood pressure reduction at final visit was not significantly greater under O [SBP: 16.6 (95% confidence interval 14.0/19.2) mmHg vs 13.0 (10.4/15.6) mmHg R, p = 0.206; DBP: 11.8 (10.3/13.3) mmHg vs 10.5 (9.0/12.0) mmHg, p = 0.351]. In the subgroup of patients with valid ABP recordings (38 O and 47 R), the reduction in 24‑h average blood pressure was significantly (p = 0.01) larger with O [SBP: 8.9 (9.8/8.1) and DBP: 5.7 (6.3/5.1) mmHg] than with R [6.7 (7.9/5.6) and 4.4 (5.1/3.7) mmHg]. The superiority of O was particularly evident in the last 4 h from the dosing interval. The proportion of patients with drug-related adverse events was comparable in the two groups (4.0% O vs 4.5% R), as well as the number of patients discontinuing study drug because of a side-effect (8 O vs 7 R). Conclusions. In elderly patients with essential arterial hypertension, O provides an effective, prolonged and well tolerated blood pressure control, with significantly better blood pressure normalization than R and represents a useful option among first-line drug treatments of hypertension in this age group.https://russjcardiol.elpub.ru/jour/article/view/1232ambulatory blood pressure monitoringessential hypertensionelderlyolmesartanramipriloffice blood pressure
spellingShingle J‑M. Mallion
S. Omboni
J. Barton
W. van Mieghem
K. Narkiewicz
P‑K. Panzer
J. G. Puig
Ch. Stefanadis
R. Zwieker
ANTIHYPERTENSIVE EFFICACY AND SAFETY OF OLMESARTAN AND RAMIPRILIN ELDERLY PATIENTS WITH MILD TO MODERATE SYSTOLIC AND DIASTOLICESSENTIAL HYPERTENSION
Российский кардиологический журнал
ambulatory blood pressure monitoring
essential hypertension
elderly
olmesartan
ramipril
office blood pressure
title ANTIHYPERTENSIVE EFFICACY AND SAFETY OF OLMESARTAN AND RAMIPRILIN ELDERLY PATIENTS WITH MILD TO MODERATE SYSTOLIC AND DIASTOLICESSENTIAL HYPERTENSION
title_full ANTIHYPERTENSIVE EFFICACY AND SAFETY OF OLMESARTAN AND RAMIPRILIN ELDERLY PATIENTS WITH MILD TO MODERATE SYSTOLIC AND DIASTOLICESSENTIAL HYPERTENSION
title_fullStr ANTIHYPERTENSIVE EFFICACY AND SAFETY OF OLMESARTAN AND RAMIPRILIN ELDERLY PATIENTS WITH MILD TO MODERATE SYSTOLIC AND DIASTOLICESSENTIAL HYPERTENSION
title_full_unstemmed ANTIHYPERTENSIVE EFFICACY AND SAFETY OF OLMESARTAN AND RAMIPRILIN ELDERLY PATIENTS WITH MILD TO MODERATE SYSTOLIC AND DIASTOLICESSENTIAL HYPERTENSION
title_short ANTIHYPERTENSIVE EFFICACY AND SAFETY OF OLMESARTAN AND RAMIPRILIN ELDERLY PATIENTS WITH MILD TO MODERATE SYSTOLIC AND DIASTOLICESSENTIAL HYPERTENSION
title_sort antihypertensive efficacy and safety of olmesartan and ramiprilin elderly patients with mild to moderate systolic and diastolicessential hypertension
topic ambulatory blood pressure monitoring
essential hypertension
elderly
olmesartan
ramipril
office blood pressure
url https://russjcardiol.elpub.ru/jour/article/view/1232
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