[Ramipril in elderly patients with mild and moderate hypertension. Clinical efficacy, effect on cerebral blood flow and intellectual functioning].
OBJECTIVE
to study different ramipril dosage regimens on cerebral blood flow and cognitive function in elderly patients with mild to moderate hypertension.


METHODS
30 out-patient hypertensive patients (13 men, 17 women, age 55-75 years, mean 62+1,5).


METHODS
After withdrawal of previous antihypertensive therapy patients were randomized to receive gradual (group 1) and more active (group 2) ramipril regimen. The starting dose (2,5 mg in group 1 and 5 mg in group 2) was increased at 2-week intervals to 10 mg daily. If target blood pressure (BP) level was not achieved hydrochlorothiazide (25 mg/day) was added. The treatment duration was 8 weeks. 24-hour BP monitoring, duplex scanning of brachiocephalic arteries were performed at baseline, after the first dose of ramipril, and after 8 weeks of therapy. Intellectual functioning was evaluated with 4 tests of memory and attention assessment.


CONCLUSIONS
Both single dose and long term ramipril treatment provided stable and steady hypertensive effect throughout 24 hours. There was no case of first dose hypotension in elderly patients. Both starting doses (2,5 mg and 5 mg) were similarly safe. Neither first dose of ramipril nor long term treatment caused impairment of cerebral blood flow. 8-week ramipril treatment in elderly hypertensive patients was associated with improvement of some characteristics of intellectual functioning.
Pogosova
G V
GV
Zhidko
N I
NI
Ivanishina
N S
NS
Gudkova
O A
OA
Avakian
G N
GN
D000368:Aged; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000008:administration & dosage*; D002560:Cerebrovascular Circulation / Q000187:drug effects* / Q000502:physiology; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000503:physiopathology; D008297:Male; D008606:Mental Processes / Q000187:drug effects* / Q000502:physiology; D008875:Middle Aged; D017257:Ramipril / Q000008:administration & dosage*; D016896:Treatment Outcome
D000806:Angiotensin-Converting Enzyme Inhibitors; D017257:Ramipril