Olmesartan vs ramipril in the treatment of hypertension and associated clinical conditions in the elderly: a reanalysis of two large double blind, randomized studies at the light of the most recent blood pressure targets recommended by guidelines

Stefano Omboni,1 Ettore Malacco,2 Jean-Michel Mallion,3 Massimo Volpe4,5 1Clinical Research Unit, Italian Institute of Telemedicine, Solbiate Arno, Varese, Italy; 2Department of Internal Medicine, Ospedale L Sacco, University of Milan, Milan, Italy; 3Cardiology and Arterial Hypertension, CHU de Gre...

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Autores principales:	Omboni S, Malacco E, Mallion JM, Volpe M
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2015
Materias:	arterial hypertension elderly guidelines olmesartan medoxomil ramipril Geriatrics RC952-954.6
Acceso en línea:	https://doaj.org/article/b08462ba962f451b96580b3be2149adc
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spelling	oai:doaj.org-article:b08462ba962f451b96580b3be2149adc2021-12-02T06:10:48ZOlmesartan vs ramipril in the treatment of hypertension and associated clinical conditions in the elderly: a reanalysis of two large double blind, randomized studies at the light of the most recent blood pressure targets recommended by guidelines1178-1998https://doaj.org/article/b08462ba962f451b96580b3be2149adc2015-10-01T00:00:00Zhttps://www.dovepress.com/olmesartan-vs-ramipril-in-the-treatment-of-hypertension-and-associated-peer-reviewed-article-CIAhttps://doaj.org/toc/1178-1998Stefano Omboni,1 Ettore Malacco,2 Jean-Michel Mallion,3 Massimo Volpe4,5 1Clinical Research Unit, Italian Institute of Telemedicine, Solbiate Arno, Varese, Italy; 2Department of Internal Medicine, Ospedale L Sacco, University of Milan, Milan, Italy; 3Cardiology and Arterial Hypertension, CHU de Grenoble, Grenoble, France; 4Division of Cardiology, II Faculty of Medicine, University of Rome “La Sapienza”, Sant’Andrea Hospital, Rome, Italy; 5IRCCS Neuromed, Pozzilli, Isernia, Italy Abstract: In this paper, we present the results of a reanalysis of the data of two large randomized, double-blind, parallel group studies with a similar design, comparing the efficacy of an angiotensin-receptor blocker (olmesartan medoxomil) with that of an angiotensin-converting enzyme inhibitor (ramipril), by applying two different blood pressure targets recently recommended by hypertension guidelines for all patients, irrespective of the presence of diabetes (<140/90 mmHg), and for elderly hypertensive patients (<150/90 mmHg). The efficacy of olmesartan was not negatively affected by age, sex, hypertension type, diabetes status or other concomitant clinical conditions, or cardiovascular risk factors. In most cases, olmesartan provided better blood pressure control than ramipril. Olmesartan was significantly more effective than ramipril in male patients, in younger patients (aged 65–69 years), in those with metabolic syndrome, obesity, dyslipidemia, preserved renal function, diastolic ± systolic hypertension, and, in general, in patients with a high or very high cardiovascular risk. Interestingly, patients previously untreated or treated with two or more antihypertensive drugs showed a significantly larger response with olmesartan than with ramipril. Thus, our results confirm the good efficacy of olmesartan in elderly hypertensives even when new blood pressure targets for antihypertensive treatment are considered. Such results may be relevant for the clinical practice, providing some hint on the possible different response of elderly hypertensive patients to two different drugs acting on the renin–angiotensin system, when patients are targeted according to the blood pressure levels recommended by recent hypertension guidelines. Keywords: arterial hypertension, elderly, guidelines, olmesartan medoxomil, ramiprilOmboni SMalacco EMallion JMVolpe MDove Medical Pressarticlearterial hypertensionelderlyguidelinesolmesartan medoxomilramiprilGeriatricsRC952-954.6ENClinical Interventions in Aging, Vol Volume 10, Pp 1575-1586 (2015)
institution	DOAJ
collection	DOAJ
language	EN
topic	arterial hypertension elderly guidelines olmesartan medoxomil ramipril Geriatrics RC952-954.6
spellingShingle	arterial hypertension elderly guidelines olmesartan medoxomil ramipril Geriatrics RC952-954.6 Omboni S Malacco E Mallion JM Volpe M Olmesartan vs ramipril in the treatment of hypertension and associated clinical conditions in the elderly: a reanalysis of two large double blind, randomized studies at the light of the most recent blood pressure targets recommended by guidelines
description	Stefano Omboni,1 Ettore Malacco,2 Jean-Michel Mallion,3 Massimo Volpe4,5 1Clinical Research Unit, Italian Institute of Telemedicine, Solbiate Arno, Varese, Italy; 2Department of Internal Medicine, Ospedale L Sacco, University of Milan, Milan, Italy; 3Cardiology and Arterial Hypertension, CHU de Grenoble, Grenoble, France; 4Division of Cardiology, II Faculty of Medicine, University of Rome “La Sapienza”, Sant’Andrea Hospital, Rome, Italy; 5IRCCS Neuromed, Pozzilli, Isernia, Italy Abstract: In this paper, we present the results of a reanalysis of the data of two large randomized, double-blind, parallel group studies with a similar design, comparing the efficacy of an angiotensin-receptor blocker (olmesartan medoxomil) with that of an angiotensin-converting enzyme inhibitor (ramipril), by applying two different blood pressure targets recently recommended by hypertension guidelines for all patients, irrespective of the presence of diabetes (<140/90 mmHg), and for elderly hypertensive patients (<150/90 mmHg). The efficacy of olmesartan was not negatively affected by age, sex, hypertension type, diabetes status or other concomitant clinical conditions, or cardiovascular risk factors. In most cases, olmesartan provided better blood pressure control than ramipril. Olmesartan was significantly more effective than ramipril in male patients, in younger patients (aged 65–69 years), in those with metabolic syndrome, obesity, dyslipidemia, preserved renal function, diastolic ± systolic hypertension, and, in general, in patients with a high or very high cardiovascular risk. Interestingly, patients previously untreated or treated with two or more antihypertensive drugs showed a significantly larger response with olmesartan than with ramipril. Thus, our results confirm the good efficacy of olmesartan in elderly hypertensives even when new blood pressure targets for antihypertensive treatment are considered. Such results may be relevant for the clinical practice, providing some hint on the possible different response of elderly hypertensive patients to two different drugs acting on the renin–angiotensin system, when patients are targeted according to the blood pressure levels recommended by recent hypertension guidelines. Keywords: arterial hypertension, elderly, guidelines, olmesartan medoxomil, ramipril
format	article
author	Omboni S Malacco E Mallion JM Volpe M
author_facet	Omboni S Malacco E Mallion JM Volpe M
author_sort	Omboni S
title	Olmesartan vs ramipril in the treatment of hypertension and associated clinical conditions in the elderly: a reanalysis of two large double blind, randomized studies at the light of the most recent blood pressure targets recommended by guidelines
title_short	Olmesartan vs ramipril in the treatment of hypertension and associated clinical conditions in the elderly: a reanalysis of two large double blind, randomized studies at the light of the most recent blood pressure targets recommended by guidelines
title_full	Olmesartan vs ramipril in the treatment of hypertension and associated clinical conditions in the elderly: a reanalysis of two large double blind, randomized studies at the light of the most recent blood pressure targets recommended by guidelines
title_fullStr	Olmesartan vs ramipril in the treatment of hypertension and associated clinical conditions in the elderly: a reanalysis of two large double blind, randomized studies at the light of the most recent blood pressure targets recommended by guidelines
title_full_unstemmed	Olmesartan vs ramipril in the treatment of hypertension and associated clinical conditions in the elderly: a reanalysis of two large double blind, randomized studies at the light of the most recent blood pressure targets recommended by guidelines
title_sort	olmesartan vs ramipril in the treatment of hypertension and associated clinical conditions in the elderly: a reanalysis of two large double blind, randomized studies at the light of the most recent blood pressure targets recommended by guidelines
publisher	Dove Medical Press
publishDate	2015
url	https://doaj.org/article/b08462ba962f451b96580b3be2149adc
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Olmesartan vs ramipril in the treatment of hypertension and associated clinical conditions in the elderly: a reanalysis of two large double blind, randomized studies at the light of the most recent blood pressure targets recommended by guidelines

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