The smoothness of blood pressure control of ramipril in essential hypertensive Thai patients evaluation by 24-hour ambulatory blood pressure monitoring.

OBJECTIVE: Evaluate the efficacy of ramipril 2.5 and 5 mg once daily on the degree and homogeneity of 24-hour blood pressure reduction in essential hypertensive Thai patients. MATERIAL AND METHOD: Nineteen male subjects, aged 30 to 60 years, with newly diagnosed essential hypertension were evaluated using the 24-hour ambulatory blood pressure (24-h ABP) measurement. RESULTS: Twelve subjects responded and/or normalized with ramipril once daily, where the office and 24-h ABP were decreased significantly from baseline (p < 0.01). The percentage and magnitude of 24-h SBP/DBP loads after treatment were significantly decreased from 92 +/- 9.7/91 +/- 15.9 to 67 +/- 23.8/65 +/- 27.6 (p < 0.01) and from 23 +/- 10.6/16 +/- 5.3 mmHg to 17 +/- 10.3/10 +/- 4.8 mmHg ( p < 0.05). Trough to peak ratio for SBP/DBP was 0.59/0.52 (overall estimated) and 0.68 +/- 0.23/0.52 +/- 0.22 (individual estimated), while the smoothness index was 0.89/1.03. CONCLUSION: Ramipril 2.5 and 5 mg once daily exerted the smooth 24-hour blood pressure reduction in essential hypertensive Thai patients.

Efficacy and safety of 12-week treatment with fenofibrate 300 mg in Thai dyslipidemic patients.

BACKGROUND: High levels of low density lipoprotein (LDL) cholesterol is a known major factor in atherosclerosis. In addition to LDL-cholesterol, an increase in the triglycerides-rich lipoprotein and a decrease in HDL-cholesterol increase the risk of coronary artery disease. Fenofibrate, a fibric acid derivative, is highly effective in reducing serum triglycerides and LDL-cholesterol and produces a modest increase in HDL-cholesterol. The present study was done to evaluate the efficacy of fenofibrate at 300 mg daily on serum lipid profiles and to study the drug safety and tolerability of fenofibrate in Thai patients. MATERIAL AND METHOD: Forty patients with elevated serum total cholesterol, LDL cholesterol were recruited for 12 weeks of 300 mg per day of fenofibrate therapy. Blood analysis for lipid profiles, liver function test, creatinine and muscle enzyme were done at the begining and end of the study. RESULTS: The mean baseline total cholesterol, LDL-cholesterol, triglycerides and HDL-cholesterol were 249 mg/dl, 160 mg/dl, 325 mg/dl and 43 mg/dl respectively. Significant changes of all lipid parameters from baseline were observed after 12 weeks of treatment. Reduction of serum total cholesterol, LDL-cholesterol and triglycerides were 16, 23, and 41 percent respectively. Increased serum HDL-cholesterol of 14 percent was also observed. One patient withdrew from the trial due to chest pain. Two asymptomatic elevated transaminase were detected during the study. CONCLUSION: Fenofibrate at 300 mg per day is effective and safe in treating Thai patients with dyslipidemia.

Efficacy and safety of rilmenidine, a selective imidazoline I1 receptor binding ligand, in mild-to-moderate Thai hypertensive patients.

BACKGROUND: Rilmenidine is an antihypertensive agent that selectively binds to imidazoline I1 receptor located in the brainstem and kidney. It acts both centrally by reducing sympathetic overactivity and in the kidney by decreasing water and sodium overload. This dual action leads to the immediate and delayed control of blood pressure caused by this drug. OBJECTIVE: The aim of this study was to assess the efficacy and safety of rilmenidine as monotherapy in mild-to-moderate essential hypertensive patients. METHOD: An 8-week, open-labeled, multicenter study was conducted in Thai patients with mild-to-moderate essential hypertension. Rilmenidine 1 mg/day was given for 8 weeks. The dose could be titrated up to 2 mg/day according to the patient's blood pressure response at week 4. The primary efficacy parameters were the mean reductions in systolic and diastolic blood pressure. The proportions of patients whose blood pressure normalized or responded were evaluated as secondary efficacy parameters. Safety parameters were assessed by the changes in heart rate and reported side effects during the treatment period. RESULTS: 103 subjects (44.7% men) with a mean age of 53 +/- 9.7 years completed the 8-week follow-up. At baseline, 46.6 per cent and 53.4 per cent of the patients were classified with mild and moderate hypertension, respectively. The mean blood pressure was 154/93 mmHg. After the 8-week treatment, there was a significant decrease in blood pressure to 140/86 mmHg (p < 0.001), with mean pressure reduction of 14/7.5 mmHg. The normalization rate was 44 per cent and the response rate was 68 per cent. No significant changes were found for mean heart rate and any laboratory parameters tested. Only 17 patients reported mild and transient side effects such as drowsiness and dryness of the mouth and throat, which required no treatment. CONCLUSION: This study has shown that rilmenidine is an effective and well tolerated monotherapy in Thai patients with mild-to-moderate essential hypertension.