Ramipril in isolated systolic hypertension of the elderly

G. Torrisi, S. Di Mauro, N. Cosentino, C. Leotta, M. Marino, E. De Bernardis, A. Distefano

Research output: Contribution to journalArticlepeer-review


This randomized, single-blinded, placebo-controlled study was performed to evaluate antihypertensive efficacy and tolerability of the angiotension-converting enzyme (ACE) inhibitor ramipril in patients with isolated systolic hypertension (ISH). ISH is a common finding in the elderly population and it is considered to be an important cardiovascular risk factor. After a 3-week wash-out, 84 patients aged between 65 and 86 years, with ISH defined as systolic blood pressure (SBP), greater than 160 mmHg and diastolic blood pressure (DBP) less than 90 mmHg, were randomized to placebo (r = 40) or ramipril (n = 44) at the initial dose of 2.5 mg/day, which after 3 weeks of treatment, was increased to 5 mg/day for another 9 weeks when SBP was greater than 160 mmHg or SBP decrease was less than 20 mmHg. At baseline, the two groups were well matched for age, body weight, DBP, SBP, and heart rate. A total of 40 patients in the treated group and 34 controls completed the study. In the ramipril group, SBP decreased in a statistically significant manner from 180.5 to 168.1 (p <0.05) after 3 weeks and to 162.1 mmHg (p <0.02) after 12 weeks. In the placebo group, SEP decreased without statistical significance (p <0.05) from 178.1 to 172.8 after 3 weeks and to 168.9 mmHg after 12 weeks. Comparison between groups was statistically significant (p <0.05) at twelve weeks. Patients' 'responder' rate was 19.5% versus 46.3% after 3 weeks (p = 0.025) and 32.4% versus 70.0% after 12 weeks (p = 0.003) in the placebo and ramipril group, respectively. No effect was observed on DBP and heart rate and similar tolerability was seen in each group. The results of this placebo-controlled study underline the clinical efficacy, tolerability, and safety of ramipril for the treatment of elderly patients with ISH.

Original languageEnglish
Pages (from-to)187-193
Number of pages7
JournalJournal of Cardiovascular Diagnosis and Procedures
Issue number3
Publication statusPublished - 1998

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Medicine (miscellaneous)


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