Document Detail

Ramipril for the prevention and treatment of cardiovascular disease.
MedLine Citation:
PMID:  12639174     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To evaluate the effectiveness of ramipril in the prevention and treatment of cardiovascular disease and determine its need for inclusion on a formulary. DATA SOURCES: A MEDLINE and PubMed database search was conducted (1987-May 2002). Only journals written in the English language were selected for review. DATA EXTRACTION AND STUDY SELECTION: Articles reporting the use of ramipril in humans were evaluated. Emphasis was placed on randomized, controlled trials assessing efficacy. DATA SYNTHESIS: Ramipril is an angiotensin-converting enzyme (ACE) inhibitor that exerts its effects through inhibition of the renin-angiotensin-aldosterone system. It exhibits a safety profile that is similar to that of other ACE inhibitors and is comparable in cost to the majority of the available agents. Clinical trials have proven the effectiveness of ACE inhibitors in the treatment of hypertension, heart failure, and nephropathy. Ramipril, however, is the only ACE inhibitor currently approved for the prevention of cardiovascular events in high-risk patients without evidence of left-ventricular dysfunction or heart failure, based on the results of the HOPE (Heart Outcomes Prevention Evaluation) trial. Whether this effect is specific to ramipril has yet to be proven. This article emphasizes the major trials involving ramipril including the AIRE (Acute Infarction Ramipril Efficacy), REIN (Ramipril Efficacy in Nephropathy), and HOPE trials. CONCLUSIONS: Although similar to other ACE inhibitors in many aspects, it cannot be assumed that the benefits shown with ramipril in the HOPE trial are a class effect. Ongoing trials should help to clarify this matter. Until this time, current evidence justifies the inclusion of ramipril on a formulary.
April D Vuong; Laura G Annis
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  The Annals of pharmacotherapy     Volume:  37     ISSN:  1060-0280     ISO Abbreviation:  Ann Pharmacother     Publication Date:  2003 Mar 
Date Detail:
Created Date:  2003-03-17     Completed Date:  2003-06-20     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  9203131     Medline TA:  Ann Pharmacother     Country:  United States    
Other Details:
Languages:  eng     Pagination:  412-9     Citation Subset:  IM    
Area Health Education Centers (AHEC), Department of Pharmacy Practice, College of Pharmacy, University of Florida, Gainesville, FL, USA.
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MeSH Terms
Angiotensin-Converting Enzyme Inhibitors / pharmacokinetics,  pharmacology,  therapeutic use*
Cardiovascular Diseases / complications,  drug therapy*,  ethnology
Continental Population Groups
Kidney Failure / complications,  physiopathology
Liver Diseases / complications,  physiopathology
Ramipril / pharmacokinetics,  pharmacology,  therapeutic use*
Randomized Controlled Trials as Topic
Reg. No./Substance:
0/Angiotensin-Converting Enzyme Inhibitors; 87333-19-5/Ramipril

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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