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SHR Neuro Krebs Kardio Lipid Stoffw Microb

Mallion, JM; Omboni, S; Barton, J; van Mieghem, W; Narkiewicz, K; Panzer, PK; Puig, JG; Stefanadis, C; Zweiker, R; .
ANTIHYPERTENSIVE EFFICACY AND SAFETY OF OLMESARTAN AND RAMIPRILIN ELDERLY PATIENTS WITH MILD TO MODERATE SYSTOLIC AND DIASTOLICESSENTIAL HYPERTENSION.
RUSS J CARDIOL. 2012; (3): 74-84. [OPEN ACCESS]
Web of Science

 

Co-Autor*innen der 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 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.

Find related publications in this database (Keywords)
ambulatory blood pressure monitoring
essential hypertension
elderly
olmesartan
ramipril
office blood pressure
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