Randomized clinical trial of angiotensin-converting enzyme inhibitor, ramipril, in patients with intermittent claudication
Background The aim was to investigate the effect of ramipril on clinical parameters in patients with peripheral arterial disease. Methods Patients with intermittent claudication were randomized to receive ramipril or placebo for 24 weeks in a double‐blind study. Outcome measures were walking distanc...
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| Veröffentlicht in: | British journal of surgery 2013-08, Vol.100 (9), p.1154-1163 |
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| creator | Shahin, Y. Cockcroft, J. R. Chetter, I. C. |
| description | Background
The aim was to investigate the effect of ramipril on clinical parameters in patients with peripheral arterial disease.
Methods
Patients with intermittent claudication were randomized to receive ramipril or placebo for 24 weeks in a double‐blind study. Outcome measures were walking distance, arterial stiffness measurement and quality of life (QoL).
Results
A total of 33 patients were included (25 men; mean(s.d.) age 64·6(7.8) years); 14 received ramipril and 19 placebo. After 24 weeks, ramipril improved maximum treadmill walking distance by an adjusted mean (95 per cent confidence interval, c.i.) of 131 (62 to 199) m (P = 0·001), improved treadmill intermittent claudication distance by 122 (56 to 188) m (P = 0·001) and improved patient‐reported walking distance by 159 (66 to 313) m (P = 0·043) compared with placebo. Ramipril reduced carotid femoral pulse wave velocity by –1·47 (95 per cent c.i. –2·40 to –0·57) m/s compared with placebo (P = 0·002). Resting ankle : brachial pressure index (ABPI) improved slightly in both ramipril and placebo groups (0·02 (95 per cent c.i. –0·08 to 0·11) versus 0·03 (–0·05 to 0·10); P = 0·830). Ramipril had a slight, non‐significant effect on QoL physical domains compared with placebo.
Conclusion
Ramipril improved walking distance in patients with claudication; however, this improvement was not related to improved ABPI but might have been due to ramipril reducing arterial stiffness. Registration number: NCT01037530 (http://www.clinicaltrials.gov).
Improves walking distance |
| doi_str_mv | 10.1002/bjs.9198 |
| format | Article |
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The aim was to investigate the effect of ramipril on clinical parameters in patients with peripheral arterial disease.
Methods
Patients with intermittent claudication were randomized to receive ramipril or placebo for 24 weeks in a double‐blind study. Outcome measures were walking distance, arterial stiffness measurement and quality of life (QoL).
Results
A total of 33 patients were included (25 men; mean(s.d.) age 64·6(7.8) years); 14 received ramipril and 19 placebo. After 24 weeks, ramipril improved maximum treadmill walking distance by an adjusted mean (95 per cent confidence interval, c.i.) of 131 (62 to 199) m (P = 0·001), improved treadmill intermittent claudication distance by 122 (56 to 188) m (P = 0·001) and improved patient‐reported walking distance by 159 (66 to 313) m (P = 0·043) compared with placebo. Ramipril reduced carotid femoral pulse wave velocity by –1·47 (95 per cent c.i. –2·40 to –0·57) m/s compared with placebo (P = 0·002). Resting ankle : brachial pressure index (ABPI) improved slightly in both ramipril and placebo groups (0·02 (95 per cent c.i. –0·08 to 0·11) versus 0·03 (–0·05 to 0·10); P = 0·830). Ramipril had a slight, non‐significant effect on QoL physical domains compared with placebo.
Conclusion
Ramipril improved walking distance in patients with claudication; however, this improvement was not related to improved ABPI but might have been due to ramipril reducing arterial stiffness. Registration number: NCT01037530 (http://www.clinicaltrials.gov).
Improves walking distance</description><identifier>ISSN: 0007-1323</identifier><identifier>EISSN: 1365-2168</identifier><identifier>DOI: 10.1002/bjs.9198</identifier><identifier>PMID: 23842829</identifier><identifier>CODEN: BJSUAM</identifier><language>eng</language><publisher>Chichester, UK: John Wiley & Sons, Ltd</publisher><subject>Angiotensin-Converting Enzyme Inhibitors - therapeutic use ; Ankle Brachial Index ; Double-Blind Method ; Female ; Hemodynamics - physiology ; Humans ; Intermittent Claudication - drug therapy ; Intermittent Claudication - physiopathology ; Male ; Middle Aged ; Prospective Studies ; Quality of Life ; Ramipril - therapeutic use ; Treatment Outcome ; Vascular Stiffness - physiology ; Walking - physiology</subject><ispartof>British journal of surgery, 2013-08, Vol.100 (9), p.1154-1163</ispartof><rights>2013 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.</rights><rights>Copyright © 2013 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3888-142802758c2b5de3d64d018d94d8e500ed1931424e143d634e62ab24925151be3</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fbjs.9198$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fbjs.9198$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,777,781,1412,27905,27906,45555,45556</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23842829$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Shahin, Y.</creatorcontrib><creatorcontrib>Cockcroft, J. R.</creatorcontrib><creatorcontrib>Chetter, I. C.</creatorcontrib><title>Randomized clinical trial of angiotensin-converting enzyme inhibitor, ramipril, in patients with intermittent claudication</title><title>British journal of surgery</title><addtitle>Br J Surg</addtitle><description>Background
The aim was to investigate the effect of ramipril on clinical parameters in patients with peripheral arterial disease.
Methods
Patients with intermittent claudication were randomized to receive ramipril or placebo for 24 weeks in a double‐blind study. Outcome measures were walking distance, arterial stiffness measurement and quality of life (QoL).
Results
A total of 33 patients were included (25 men; mean(s.d.) age 64·6(7.8) years); 14 received ramipril and 19 placebo. After 24 weeks, ramipril improved maximum treadmill walking distance by an adjusted mean (95 per cent confidence interval, c.i.) of 131 (62 to 199) m (P = 0·001), improved treadmill intermittent claudication distance by 122 (56 to 188) m (P = 0·001) and improved patient‐reported walking distance by 159 (66 to 313) m (P = 0·043) compared with placebo. Ramipril reduced carotid femoral pulse wave velocity by –1·47 (95 per cent c.i. –2·40 to –0·57) m/s compared with placebo (P = 0·002). Resting ankle : brachial pressure index (ABPI) improved slightly in both ramipril and placebo groups (0·02 (95 per cent c.i. –0·08 to 0·11) versus 0·03 (–0·05 to 0·10); P = 0·830). Ramipril had a slight, non‐significant effect on QoL physical domains compared with placebo.
Conclusion
Ramipril improved walking distance in patients with claudication; however, this improvement was not related to improved ABPI but might have been due to ramipril reducing arterial stiffness. Registration number: NCT01037530 (http://www.clinicaltrials.gov).
Improves walking distance</description><subject>Angiotensin-Converting Enzyme Inhibitors - therapeutic use</subject><subject>Ankle Brachial Index</subject><subject>Double-Blind Method</subject><subject>Female</subject><subject>Hemodynamics - physiology</subject><subject>Humans</subject><subject>Intermittent Claudication - drug therapy</subject><subject>Intermittent Claudication - physiopathology</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Prospective Studies</subject><subject>Quality of Life</subject><subject>Ramipril - therapeutic use</subject><subject>Treatment Outcome</subject><subject>Vascular Stiffness - physiology</subject><subject>Walking - physiology</subject><issn>0007-1323</issn><issn>1365-2168</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpd0VFPFDEQAODGaOQAE3-B2cQXH1jstLt77aMQQclFE8CY-NJ0twPMuds9265w9-vtAWLiSyfpfJmZdhh7DfwQOBfv22U81KDVMzYD2dSlgEY9ZzPO-bwEKeQO241xyTlIXouXbEdIVQkl9Ixtzq1340AbdEXXk6fO9kUKlM_xqrD-msaEPpIvu9H_xpDIXxfoN-sBC_I31FIaw0ER7ECrQP1BvixWNhH6FItbSjf5ImEYKOUyKbewk8s9Eo1-n724sn3EV49xj307-Xh5_KlcfD39fPxhUXZSKVVCnpSLea060dYOpWsqx0E5XTmFNefoQMuMKoQqJ2WFjbCtqLSooYYW5R5791B3FcZfE8ZkBood9r31OE7RgNQ6Y9HITN_-R5fjFHye7l5BBQAiqzePamoHdCY_fLBhbf7-agblA7ilHtdPeeBmuy2Tt2W22zJHZxfb-M9TTHj35G34aZq5nNfm-5dT0-iTH_zivDEL-QdyjZZY</recordid><startdate>201308</startdate><enddate>201308</enddate><creator>Shahin, Y.</creator><creator>Cockcroft, J. R.</creator><creator>Chetter, I. C.</creator><general>John Wiley & Sons, Ltd</general><general>Oxford University Press</general><scope>BSCLL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>K9.</scope><scope>7X8</scope></search><sort><creationdate>201308</creationdate><title>Randomized clinical trial of angiotensin-converting enzyme inhibitor, ramipril, in patients with intermittent claudication</title><author>Shahin, Y. ; Cockcroft, J. R. ; Chetter, I. C.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3888-142802758c2b5de3d64d018d94d8e500ed1931424e143d634e62ab24925151be3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Angiotensin-Converting Enzyme Inhibitors - therapeutic use</topic><topic>Ankle Brachial Index</topic><topic>Double-Blind Method</topic><topic>Female</topic><topic>Hemodynamics - physiology</topic><topic>Humans</topic><topic>Intermittent Claudication - drug therapy</topic><topic>Intermittent Claudication - physiopathology</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Prospective Studies</topic><topic>Quality of Life</topic><topic>Ramipril - therapeutic use</topic><topic>Treatment Outcome</topic><topic>Vascular Stiffness - physiology</topic><topic>Walking - physiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Shahin, Y.</creatorcontrib><creatorcontrib>Cockcroft, J. R.</creatorcontrib><creatorcontrib>Chetter, I. C.</creatorcontrib><collection>Istex</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>British journal of surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Shahin, Y.</au><au>Cockcroft, J. R.</au><au>Chetter, I. C.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Randomized clinical trial of angiotensin-converting enzyme inhibitor, ramipril, in patients with intermittent claudication</atitle><jtitle>British journal of surgery</jtitle><addtitle>Br J Surg</addtitle><date>2013-08</date><risdate>2013</risdate><volume>100</volume><issue>9</issue><spage>1154</spage><epage>1163</epage><pages>1154-1163</pages><issn>0007-1323</issn><eissn>1365-2168</eissn><coden>BJSUAM</coden><abstract>Background
The aim was to investigate the effect of ramipril on clinical parameters in patients with peripheral arterial disease.
Methods
Patients with intermittent claudication were randomized to receive ramipril or placebo for 24 weeks in a double‐blind study. Outcome measures were walking distance, arterial stiffness measurement and quality of life (QoL).
Results
A total of 33 patients were included (25 men; mean(s.d.) age 64·6(7.8) years); 14 received ramipril and 19 placebo. After 24 weeks, ramipril improved maximum treadmill walking distance by an adjusted mean (95 per cent confidence interval, c.i.) of 131 (62 to 199) m (P = 0·001), improved treadmill intermittent claudication distance by 122 (56 to 188) m (P = 0·001) and improved patient‐reported walking distance by 159 (66 to 313) m (P = 0·043) compared with placebo. Ramipril reduced carotid femoral pulse wave velocity by –1·47 (95 per cent c.i. –2·40 to –0·57) m/s compared with placebo (P = 0·002). Resting ankle : brachial pressure index (ABPI) improved slightly in both ramipril and placebo groups (0·02 (95 per cent c.i. –0·08 to 0·11) versus 0·03 (–0·05 to 0·10); P = 0·830). Ramipril had a slight, non‐significant effect on QoL physical domains compared with placebo.
Conclusion
Ramipril improved walking distance in patients with claudication; however, this improvement was not related to improved ABPI but might have been due to ramipril reducing arterial stiffness. Registration number: NCT01037530 (http://www.clinicaltrials.gov).
Improves walking distance</abstract><cop>Chichester, UK</cop><pub>John Wiley & Sons, Ltd</pub><pmid>23842829</pmid><doi>10.1002/bjs.9198</doi><tpages>10</tpages><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; Wiley Online Library Journals Frontfile Complete; Oxford University Press Journals All Titles (1996-Current) |
| subjects | Angiotensin-Converting Enzyme Inhibitors - therapeutic use Ankle Brachial Index Double-Blind Method Female Hemodynamics - physiology Humans Intermittent Claudication - drug therapy Intermittent Claudication - physiopathology Male Middle Aged Prospective Studies Quality of Life Ramipril - therapeutic use Treatment Outcome Vascular Stiffness - physiology Walking - physiology |
| title | Randomized clinical trial of angiotensin-converting enzyme inhibitor, ramipril, in patients with intermittent claudication |
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