Experience of ramipril (Hartil) usage in patients with high cardiovascular risk (the OPTIMIST study

I.A. Velizhanina¹*, L.I. Gapon¹, E.S. Velizhanina¹, M.I. Shupina², A.V. Rudakov¹, T.S. Bondarenko¹

¹ Tyumen Cardiology Center, Affiliate of Research Institute for Cardiology of Siberian Branch of Russian Academy of Medical Sciences, Melnikaite ul. 111,

Tyumen, 625026 Russia

² Omsk State Medical Academy of Federal Agency for Health Care and Social Development. Lenina ul. 12, Omsk, 644043 Russia

Aim. To evaluate efficacy and safety of ramipril (Hartil, Egis) in treatment of patients with different cardiovascular risk (according to arterial hypertension (HT) risk stratification) in real clinical practice.

Material and methods. 998 patients (424 men and 574 women; aged 57,4Ѓ}0,4 y.o.) with HT; with combination of HT and ischemic heart disease; with ischemic heart disease and high normal blood pressure (BP) were included in the open non-control non-comparative multicenter phase IV study. The anamnesis data collection, physical examination, evaluation of risk factors, the target organ damage, the associated cardiovascular diseases, total cardiovascular risk, previous therapy, and also BP measurement were performed.

All patients received ramipril within 8 weeks additionally to previous antihypertensive therapy. The BP measurement was performed initially, after 4 and 8 weeks of therapy. Achievement of target BP level (BP<140/90 or <130/80 mm Hg in patients of high or very high cardiovascular risk) was used as efficacy criterion.

Results. 790 (82,1%) hypertensive patients used antihypertensive therapy before the study. 675 (85,4%) patients received ACE inhibitors, 435 (55%) patients - beta-blockers, 230 (29,1%) patients - calcium channel blockers, 420 (53,2%) patients – diuretics and 28 (3,5%) patients - angiotensin II receptor blockers. Ramipril additionally to previous therapy provided achievement of target BP in 69,4% of patients with high and in 64,8% of patients with very high cardiovascular risk.

Conclusion. Addition of a ramipril to the treatment of patients with high and very high cardiovascular risk increases efficacy of the therapy.

Key words: arterial hypertension, cardiovascular risk, ramipril.

Rational Pharmacother Cardiol 2009;(6):13-18

*Corresponding author: dr.velizhanina( at) mail.ru