Assessment of the Efficacy, Tolerance, and Safety of Ramipril in Diabetic Patients with Mild-to-Moderate Hypertension

Abstract

Six double-blind studies were designed to assess the efficacy, tolerance, and safety of the angiotensin-converting enzyme inhibitor ramipril in patients with mild-to-moderate essential hypertension. Of 1,189 hypertensive patients in these studies, 105 patients were diabetic. They were randomly assigned either to a ramipril monotherapy group (1.25-10 mg/day) or to one of the following treatment groups: ramipril (5 mg/day) plus piretanide (3 mg/day), captopril (100 mg/day), enalapril (10-20 mg/day), hydrochlorothiazide (50 mg/day), or atenolol (100 mg/day). In all studies, a 4-week single-blind placebo run-in phase was followed by a 6-week double-blind active treatment phase. Significant reductions in blood pressure were achieved with all antihypertensive agents. No statistically significant deleterious effects were observed on concentrations of blood glucose, although diabetics who received hydrochlorothiazide showed slight increases in blood glucose levels. Ramipril was well tolerated by diabetic patients, and no serious adverse events occurred. Adverse events reported were typical of ACE inhibitors.