Ace inhibitor ramipril is more effective than the β-blocker atenolol in reducing left ventricular mass in hypertension. Results of the RACE (Ramipril cardioprotective evaluation) study

Enrico Agabiti-Rosei, Ettore Ambrosioni, Cesare Dal Palù, M. Lorenza Muiesan, Alberto Zanchetti, A. Zanchetti, C. Cuspidi, A. Libretti, R. Sega, C. Mazzola, C. Piemonti, C. Pasotti, A. Capra, E. Uslenghi, G. Ugliengo, C. Dal Palu, A. Semplicini, P. Maiolino, A. Rossi, P. PascottoD. D’Este, C. Martines, D. Marchese, D. Zanuttini, D. Pavan, P. Zonzin, R. Fiorencis, R. Miori, G. De Venuto, D. Brachetti, U. De Castro, A. Brunelli, A. Alboni, F. Ippolito, G. Tumiotto, S. Bosi, C. Guadagni, R. Agosta

Research output: Contribution to journalArticle

Abstract

Objectives: To compare the effect of the angiotensin converting enzyme (ACE) inhibitor ramipril with that of the β-blocker atenolol on reversal of left ventricularhypertrophy, on blood pressure and on other echocardiographic parameters. Design: The study was conducted in accord with the PROBE(prospective randomizedopen blinded endpoint) design. Randomized treatment either with ramipril or withatenolol was continued for 6 months, and echocardiograms were recorded beforeand after 3 and 6 months of treatment. The echo tracings were blindly evaluated ina single reading centre. Methods: M-mode, two-dimensional guided echocardiography was used to measureleft ventricular wall thicknesses and dimensions, from which left ventricular masswascalculated, according to the Penn convention. Results: Of 193 patients at 16 centres, 111 had echocardiograms that could bequantitatively evaluated. The primary analysis of the study was performed using datafrom those patients. In addition, echocardiograms of 88 patients were analysed onan ’according to protocol’ basis (patients with preset values of left ventricular mass). Systolic and diastolic blood pressures were significantly reduced both by ramipriland by atenolol without any significant difference between the two drug treatments. The heart rate was significantly reduced by atenolol only. Both the ’primary’ and the’according to protocol’ analysesshowed that the left ventricular masswas significantlyreduced by ramipril only. Comparison between treatments according to a multivariateanalysis demonstrated a significantly greater reduction in left ventricular massduringramipril than during atenolol treatment. Conclusions: The present study is the first of suitably large size in which a directcomparison of the effects of an ACE inhibitor and a β-blocker on echocardiographicleft ventricular mass has been performed. It has demonstrated that ramipril ismore effective than atenolol in reversing left ventricular hypertrophy in essentialhypertensive patients.

Original languageEnglish
Pages (from-to)1325-1334
Number of pages10
JournalJournal of Hypertension
Volume13
Issue number11
Publication statusPublished - 1995

Fingerprint

Ramipril
Atenolol
Hypertension
Blood Pressure
Angiotensin-Converting Enzyme Inhibitors
Therapeutics
Left Ventricular Hypertrophy
Echocardiography
Reading
Heart Rate
Pharmaceutical Preparations

Keywords

  • Angiotensin converting enzyme inhibitors
  • Left ventricular hypertrophy regression
  • β-blockers

ASJC Scopus subject areas

  • Physiology
  • Cardiology and Cardiovascular Medicine
  • Internal Medicine
  • Endocrinology

Cite this

Agabiti-Rosei, E., Ambrosioni, E., Palù, C. D., Muiesan, M. L., Zanchetti, A., Zanchetti, A., ... Agosta, R. (1995). Ace inhibitor ramipril is more effective than the β-blocker atenolol in reducing left ventricular mass in hypertension. Results of the RACE (Ramipril cardioprotective evaluation) study. Journal of Hypertension, 13(11), 1325-1334.

Ace inhibitor ramipril is more effective than the β-blocker atenolol in reducing left ventricular mass in hypertension. Results of the RACE (Ramipril cardioprotective evaluation) study. / Agabiti-Rosei, Enrico; Ambrosioni, Ettore; Palù, Cesare Dal; Muiesan, M. Lorenza; Zanchetti, Alberto; Zanchetti, A.; Cuspidi, C.; Libretti, A.; Sega, R.; Mazzola, C.; Piemonti, C.; Pasotti, C.; Capra, A.; Uslenghi, E.; Ugliengo, G.; Dal Palu, C.; Semplicini, A.; Maiolino, P.; Rossi, A.; Pascotto, P.; D’Este, D.; Martines, C.; Marchese, D.; Zanuttini, D.; Pavan, D.; Zonzin, P.; Fiorencis, R.; Miori, R.; De Venuto, G.; Brachetti, D.; De Castro, U.; Brunelli, A.; Alboni, A.; Ippolito, F.; Tumiotto, G.; Bosi, S.; Guadagni, C.; Agosta, R.

In: Journal of Hypertension, Vol. 13, No. 11, 1995, p. 1325-1334.

Research output: Contribution to journalArticle

Agabiti-Rosei, E, Ambrosioni, E, Palù, CD, Muiesan, ML, Zanchetti, A, Zanchetti, A, Cuspidi, C, Libretti, A, Sega, R, Mazzola, C, Piemonti, C, Pasotti, C, Capra, A, Uslenghi, E, Ugliengo, G, Dal Palu, C, Semplicini, A, Maiolino, P, Rossi, A, Pascotto, P, D’Este, D, Martines, C, Marchese, D, Zanuttini, D, Pavan, D, Zonzin, P, Fiorencis, R, Miori, R, De Venuto, G, Brachetti, D, De Castro, U, Brunelli, A, Alboni, A, Ippolito, F, Tumiotto, G, Bosi, S, Guadagni, C & Agosta, R 1995, 'Ace inhibitor ramipril is more effective than the β-blocker atenolol in reducing left ventricular mass in hypertension. Results of the RACE (Ramipril cardioprotective evaluation) study', Journal of Hypertension, vol. 13, no. 11, pp. 1325-1334.
Agabiti-Rosei, Enrico ; Ambrosioni, Ettore ; Palù, Cesare Dal ; Muiesan, M. Lorenza ; Zanchetti, Alberto ; Zanchetti, A. ; Cuspidi, C. ; Libretti, A. ; Sega, R. ; Mazzola, C. ; Piemonti, C. ; Pasotti, C. ; Capra, A. ; Uslenghi, E. ; Ugliengo, G. ; Dal Palu, C. ; Semplicini, A. ; Maiolino, P. ; Rossi, A. ; Pascotto, P. ; D’Este, D. ; Martines, C. ; Marchese, D. ; Zanuttini, D. ; Pavan, D. ; Zonzin, P. ; Fiorencis, R. ; Miori, R. ; De Venuto, G. ; Brachetti, D. ; De Castro, U. ; Brunelli, A. ; Alboni, A. ; Ippolito, F. ; Tumiotto, G. ; Bosi, S. ; Guadagni, C. ; Agosta, R. / Ace inhibitor ramipril is more effective than the β-blocker atenolol in reducing left ventricular mass in hypertension. Results of the RACE (Ramipril cardioprotective evaluation) study. In: Journal of Hypertension. 1995 ; Vol. 13, No. 11. pp. 1325-1334.
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title = "Ace inhibitor ramipril is more effective than the β-blocker atenolol in reducing left ventricular mass in hypertension. Results of the RACE (Ramipril cardioprotective evaluation) study",
abstract = "Objectives: To compare the effect of the angiotensin converting enzyme (ACE) inhibitor ramipril with that of the β-blocker atenolol on reversal of left ventricularhypertrophy, on blood pressure and on other echocardiographic parameters. Design: The study was conducted in accord with the PROBE(prospective randomizedopen blinded endpoint) design. Randomized treatment either with ramipril or withatenolol was continued for 6 months, and echocardiograms were recorded beforeand after 3 and 6 months of treatment. The echo tracings were blindly evaluated ina single reading centre. Methods: M-mode, two-dimensional guided echocardiography was used to measureleft ventricular wall thicknesses and dimensions, from which left ventricular masswascalculated, according to the Penn convention. Results: Of 193 patients at 16 centres, 111 had echocardiograms that could bequantitatively evaluated. The primary analysis of the study was performed using datafrom those patients. In addition, echocardiograms of 88 patients were analysed onan ’according to protocol’ basis (patients with preset values of left ventricular mass). Systolic and diastolic blood pressures were significantly reduced both by ramipriland by atenolol without any significant difference between the two drug treatments. The heart rate was significantly reduced by atenolol only. Both the ’primary’ and the’according to protocol’ analysesshowed that the left ventricular masswas significantlyreduced by ramipril only. Comparison between treatments according to a multivariateanalysis demonstrated a significantly greater reduction in left ventricular massduringramipril than during atenolol treatment. Conclusions: The present study is the first of suitably large size in which a directcomparison of the effects of an ACE inhibitor and a β-blocker on echocardiographicleft ventricular mass has been performed. It has demonstrated that ramipril ismore effective than atenolol in reversing left ventricular hypertrophy in essentialhypertensive patients.",
keywords = "Angiotensin converting enzyme inhibitors, Left ventricular hypertrophy regression, β-blockers",
author = "Enrico Agabiti-Rosei and Ettore Ambrosioni and Pal{\`u}, {Cesare Dal} and Muiesan, {M. Lorenza} and Alberto Zanchetti and A. Zanchetti and C. Cuspidi and A. Libretti and R. Sega and C. Mazzola and C. Piemonti and C. Pasotti and A. Capra and E. Uslenghi and G. Ugliengo and {Dal Palu}, C. and A. Semplicini and P. Maiolino and A. Rossi and P. Pascotto and D. D’Este and C. Martines and D. Marchese and D. Zanuttini and D. Pavan and P. Zonzin and R. Fiorencis and R. Miori and {De Venuto}, G. and D. Brachetti and {De Castro}, U. and A. Brunelli and A. Alboni and F. Ippolito and G. Tumiotto and S. Bosi and C. Guadagni and R. Agosta",
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TY - JOUR

T1 - Ace inhibitor ramipril is more effective than the β-blocker atenolol in reducing left ventricular mass in hypertension. Results of the RACE (Ramipril cardioprotective evaluation) study

AU - Agabiti-Rosei, Enrico

AU - Ambrosioni, Ettore

AU - Palù, Cesare Dal

AU - Muiesan, M. Lorenza

AU - Zanchetti, Alberto

AU - Zanchetti, A.

AU - Cuspidi, C.

AU - Libretti, A.

AU - Sega, R.

AU - Mazzola, C.

AU - Piemonti, C.

AU - Pasotti, C.

AU - Capra, A.

AU - Uslenghi, E.

AU - Ugliengo, G.

AU - Dal Palu, C.

AU - Semplicini, A.

AU - Maiolino, P.

AU - Rossi, A.

AU - Pascotto, P.

AU - D’Este, D.

AU - Martines, C.

AU - Marchese, D.

AU - Zanuttini, D.

AU - Pavan, D.

AU - Zonzin, P.

AU - Fiorencis, R.

AU - Miori, R.

AU - De Venuto, G.

AU - Brachetti, D.

AU - De Castro, U.

AU - Brunelli, A.

AU - Alboni, A.

AU - Ippolito, F.

AU - Tumiotto, G.

AU - Bosi, S.

AU - Guadagni, C.

AU - Agosta, R.

PY - 1995

Y1 - 1995

N2 - Objectives: To compare the effect of the angiotensin converting enzyme (ACE) inhibitor ramipril with that of the β-blocker atenolol on reversal of left ventricularhypertrophy, on blood pressure and on other echocardiographic parameters. Design: The study was conducted in accord with the PROBE(prospective randomizedopen blinded endpoint) design. Randomized treatment either with ramipril or withatenolol was continued for 6 months, and echocardiograms were recorded beforeand after 3 and 6 months of treatment. The echo tracings were blindly evaluated ina single reading centre. Methods: M-mode, two-dimensional guided echocardiography was used to measureleft ventricular wall thicknesses and dimensions, from which left ventricular masswascalculated, according to the Penn convention. Results: Of 193 patients at 16 centres, 111 had echocardiograms that could bequantitatively evaluated. The primary analysis of the study was performed using datafrom those patients. In addition, echocardiograms of 88 patients were analysed onan ’according to protocol’ basis (patients with preset values of left ventricular mass). Systolic and diastolic blood pressures were significantly reduced both by ramipriland by atenolol without any significant difference between the two drug treatments. The heart rate was significantly reduced by atenolol only. Both the ’primary’ and the’according to protocol’ analysesshowed that the left ventricular masswas significantlyreduced by ramipril only. Comparison between treatments according to a multivariateanalysis demonstrated a significantly greater reduction in left ventricular massduringramipril than during atenolol treatment. Conclusions: The present study is the first of suitably large size in which a directcomparison of the effects of an ACE inhibitor and a β-blocker on echocardiographicleft ventricular mass has been performed. It has demonstrated that ramipril ismore effective than atenolol in reversing left ventricular hypertrophy in essentialhypertensive patients.

AB - Objectives: To compare the effect of the angiotensin converting enzyme (ACE) inhibitor ramipril with that of the β-blocker atenolol on reversal of left ventricularhypertrophy, on blood pressure and on other echocardiographic parameters. Design: The study was conducted in accord with the PROBE(prospective randomizedopen blinded endpoint) design. Randomized treatment either with ramipril or withatenolol was continued for 6 months, and echocardiograms were recorded beforeand after 3 and 6 months of treatment. The echo tracings were blindly evaluated ina single reading centre. Methods: M-mode, two-dimensional guided echocardiography was used to measureleft ventricular wall thicknesses and dimensions, from which left ventricular masswascalculated, according to the Penn convention. Results: Of 193 patients at 16 centres, 111 had echocardiograms that could bequantitatively evaluated. The primary analysis of the study was performed using datafrom those patients. In addition, echocardiograms of 88 patients were analysed onan ’according to protocol’ basis (patients with preset values of left ventricular mass). Systolic and diastolic blood pressures were significantly reduced both by ramipriland by atenolol without any significant difference between the two drug treatments. The heart rate was significantly reduced by atenolol only. Both the ’primary’ and the’according to protocol’ analysesshowed that the left ventricular masswas significantlyreduced by ramipril only. Comparison between treatments according to a multivariateanalysis demonstrated a significantly greater reduction in left ventricular massduringramipril than during atenolol treatment. Conclusions: The present study is the first of suitably large size in which a directcomparison of the effects of an ACE inhibitor and a β-blocker on echocardiographicleft ventricular mass has been performed. It has demonstrated that ramipril ismore effective than atenolol in reversing left ventricular hypertrophy in essentialhypertensive patients.

KW - Angiotensin converting enzyme inhibitors

KW - Left ventricular hypertrophy regression

KW - β-blockers

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