Safety and tolerability of ramipril 10 mg in patients at high risk of cardiovascular events: an observational study.

To assess the safety and tolerability of ramipril 10 mg in patients at high risk of cardiovascular (CV) events by observing the levels of blood pressure (BP) and by recording the incidence of cough in these patients, a study was conducted in a total of 1048 patients who participated in the registry. Eligible patients in this prospective, observational, longitudinal, multicentre registry included all normotensives--including treated hypertensives--with BP <140/90 mm Hg, a history of coronary aritery disease and a history of cerebrovascular disease, peripheral arterial disease or diabetes (with micro-albuminuria) or dyslipidaemia, in whom ramipril was indicated for CV risk reduction and had been prescribed by the treating physician. The primary outcome was the effect on BP at 8 weeks, and the secondary outcome was the incidence of cough at 8 weeks. Ramipril was initiated at 2.5 mg once daily (OD) for a week, followed by 5 mg OD for 3 weeks and was then increased to 10 mg OD. Data was analysed using ANOVA and Chi-square test. A total of 1,048 patients participated in this registry; 868 (82.82%) continued with the treatment till the end of the registry (ie, 8 weeks). At baseline, systolic BP was 130.10 +/- 5.38 mm Hg, while diastolic BP was 81.07 +/- 4.36 mm Hg. At 8 weeks, these values changed non-significantly to 123.41 +/- 6.33 mm Hg and 79.03 +/- 4.84 mm Hg, respectively. At week 1, 41 patients had cough, which increased non-significantly to 58 by week 8. Only 6 patients complained of severe cough at week 8, which did not lead to treatment discontinuation. Tolerability of the treatment was assessed to be 'excellent' or 'good' by 63.3% patients and 67% physicians. Treatment with ramipril 10 mg daily in patients with high risk of CV events and normal/ controlled BP produced neither a significant fall in BP nor significant adverse events in real-world clinical practice and was well tolerated.

Safety and tolerability of ramipril 10 mg in patients at high risk of cardiovascular events: an observational study.

OBJECTIVE: To assess the safety and tolerability of ramipril 10 mg in patients at high risk of cardiovascular (CV) events by observing the levels of blood pressure (BP) and by recording the incidence of cough in these patients. METHODS: Eligible patients in this prospective, observational, longitudinal, multicentre registry included all normotensives-including treated hypertensives-with BP <140/90 mm Hg, a history of coronary artery disease and a history of cerebrovascular disease, peripheral arterial disease or diabetes (with microalbuminuria), or dyslipidaemia, in whom ramipril was indicated for CV risk reduction and had been prescribed by the treating physician. The primary outcome was the effect on BP at 8 weeks, and the secondary outcome was the incidence of cough at 8 weeks. Ramipril was initiated at 2.5 mg once daily (o.d.) for a week, followed by 5 mg o.d. for 3 weeks and was then increased to 10 mg o.d. Data were analyzed using ANOVA and Chi square test. RESULTS: A total of 1,048 patients participated in this registry; 868 (82.87 percent;) continued with the treatment till the end of the registry (i.e., 8 weeks). At baseline, systolic BP was 130.1 +/- 5.38 mm Hg, while diastolic BP was 81.07 +/- 4.36 mm Hg. At 8 weeks, these values changed non-significantly to 123.41 +/- 6.33 mm Hg and 79.03 +/- 4.84 mm Hg, respectively. At week 1, 7.1% of patients had cough, which increased non-significantly to 10% by week 8. Only 6 patients complained of severe cough at week 8, which did not lead to treatment discontinuation. Tolerability of the treatment was assessed to be "excellent" or "good" by 63.3% patients and 67% physicians. CONCLUSIONS: Treatment with ramipril 10 mg daily in patients with high risk of CV events and normal/controlled BP produced neither a significant fall in BP nor significant adverse events in real-world clinical practice and was well tolerated.

Blood pressure control among Indians with hypertension: the I-Target survey.

Hypertension, a major cardiovascular disease risk factor, is increasing in India. Though several studies have studied the prevalence and causes of hypertension in India, only few have examined the control of blood pressure (BP) among people with hypertension. The I-Target survey was carried out to assess the extent of BP control among Indian patients with hypertension receiving antihypertension medications. A total of 270 physicians from four zones of India included 3402 patients with hypertension who were undergoing treatment. They collected information on BP levels, current medication and presence of other risk factors, and determined the average systolic and diastolic BP in hypertensive patients. Of the study population, 1435 patients (42.2%) had diabetes and 787 (23.1%) had coronary artery disease (CAD). Overall, 70.5% patients did not reach target systolic BP (SBP) goal and 36.9% patients did not reach diastolic BP (DBP) goal. Only 27.3% patients had both SBP and DBP under control. Among patients with diabetes, 81.1% had uncontrolled SBP and 76.2% had uncontrolled DBP. In patients with CAD, 71.8% of SBP and 38.5% of DBP readings were outside the recommended target BP levels. Regardless of comorbidities-hypercholesterolaemia, myocardial infarct, metabolic syndrome, stroke, diabetic nephropathy or obesity--the average SBP and DBP were higher than target BP levels. Among patients with hypertension, control of BP to recommended targets was very poor, only to the extent of 27.3%. The average BP of hypertensive patients with comorbidities like diabetes and CAD was also higher than the BP goals recommended by international and local guidelines. Thus, there is an urgent need to increase awareness among patients with hypertension and to ensure that BP goals are achieved.