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Randomized clinical trial of angiotensin-converting enzyme inhibitor, ramipril, in patients with intermittent claudication

Shahin, Y., Cockcroft, John Ronald and Chetter, I. C. 2013. Randomized clinical trial of angiotensin-converting enzyme inhibitor, ramipril, in patients with intermittent claudication. British Journal of Surgery 100 (9) , pp. 1154-1163. 10.1002/bjs.9198

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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 (

Item Type: Article
Date Type: Publication
Status: Published
Schools: Medicine
Subjects: R Medicine > RC Internal medicine
R Medicine > RM Therapeutics. Pharmacology
R Medicine > RS Pharmacy and materia medica
Publisher: Wiley-Blackwell
ISSN: 0007-1323
Last Modified: 04 Jun 2017 06:30

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