HOPE trial hinted this possibility now PAD trial
which is published JAMA Feb 6, 2013 revels, benfit of ramipril in PAD patients.
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212 patents average aged 65 years were randomized to 10mg of ramipril and placebo
for 24 weeks. Inclusion criteria were ankle brachial index less than 0.9 at least
in one leg, history of claudication in unilateral or bilateral legs, stable
medication for 24 weeks.
Exclusion criteria were Limiting coronary artery
disease, Renal failure (serum creatinine more than 0.20 mmol/L), and Current
treatment or treatment within the previous 6 months with ACE inhibitors or
angiotensin II receptor antagonists
Constant load Thread meal test with 3.2 km/h and 12%
grade was done both at beginning and at end of 6 months. At 6months mean
walking distance increased in ramipril group compared to placebo and that was75
-second (95% CI, 60-89 seconds, P less than 0.001) and peak walking distance increased
by 255-second (95% CI, 215-295 seconds, P less than 0.001)
The benfit of ramipril was 77% increase in pain-free
walking time, a 123% increase in maximum walking time, and a 132% increase in
maximum walking distance.
The benfit of ramipril in PAD patients is more than
expensive alternatives pentoxifylline and cilostazol.
Labels: For Doctors, PAD, Patient Information