ramipril and Carotid-Stenosis

We wished to determine in asymptomatic hypertensive patients with > or = 70% stenosis of an internal carotid artery the change in regional cerebral blood flow (rCBF) produced by ramipril and enalapril and to evaluate the influence of age on drug-induced changes in rCBF. In a prospective, randomized, single-blind, placebo-controlled investigation, using the 133Xenon inhalation technique, we assessed baseline rCBF in 15 patients (9 men and 6 women aged 60-79 years) after a 24-h antihypertensive drug-free period. All patients then received a single 5-mg oral dose of ramipril, enalapril, or placebo. rCBF was reassessed 2 h postdose. There was no significant change in the median rCBF in any of the three treatment groups. Neither did we observe any lateralization of BF to any specific cerebral region in any of the three groups. There were no observed or patient-reported adverse events (AE). Single 5-mg oral doses of either ramipril or enalapril did not decrease CBF significantly in asymptomatic hypertensive patients with > or = 70% stenosis of an internal carotid artery and are probably safe starting doses in such patients. In addition, this effect was not modified by age.

Topics: Age Factors; Aged; Angiotensin-Converting Enzyme Inhibitors; Carotid Artery, Internal; Carotid Stenosis; Cerebrovascular Circulation; Enalapril; Female; Humans; Male; Middle Aged; Prospective Studies; Ramipril

Topics: Angiotensin-Converting Enzyme Inhibitors; Arteriosclerosis; Carotid Stenosis; Disease Progression; Humans; Ramipril; Randomized Controlled Trials as Topic; Vitamin E