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SHR Neuro Cancer Cardio Lipid Metab Microb
Mallion, JM; Omboni, S; Barton, J; Van Mieghem, W; Narkiewicz, K; Panzer, PK; Puig, JG; Stefanadis, C; Zweiker, R; On Behalf of the Study Group.
Antihypertensive efficacy and safety of olmesartan and ramipril in elderly patients with mild to moderate systolic and diastolic essential hypertension.
Blood Press. 2011; 20(S1): 3-11.
Doi: 10.3109/08037051.2010.532332
Web of Science
PubMed
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- Co-authors Med Uni Graz
- Zweiker Robert
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- Abstract:
- 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 double-blind 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 0 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 0 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.
- Find related publications in this database (using NLM MeSH Indexing)
- Aged -
- Aged, 80 and over -
- Angiotensin II Type 1 Receptor Blockers - therapeutic use
- Angiotensin-Converting Enzyme Inhibitors - therapeutic use
- Antihypertensive Agents - administration and dosage
- Blood Pressure - drug effects
- Blood Pressure Determination -
- Blood Pressure Monitoring, Ambulatory -
- Diastole - drug effects
- Double-Blind Method -
- Female -
- Humans -
- Hypertension - drug therapy
- Imidazoles - administration and dosage
- Male -
- Ramipril - administration and dosage
- Systole - drug effects
- Tetrazoles - administration and dosage
- Find related publications in this database (Keywords)
- Ambulatory blood pressure monitoring
- essential hypertension
- elderly
- olmesartan
- ramipril
- office blood pressure