Featured Research

from universities, journals, and other organizations

ACE inhibitor for PAD may improve pain-free walking

Date:
February 5, 2013
Source:
American Medical Association (AMA)
Summary:
Among patients with peripheral artery disease and intermittent claudication (pain in the calf that comes and goes, typically felt while walking), 24 weeks of treatment with the angiotensin-converting enzyme (ACE) inhibitor ramipril was associated with improvement in pain-free and maximum walking times and the physical health aspect of quality of life, according to a new study.

Among patients with peripheral artery disease and intermittent claudication (pain in the calf that comes and goes, typically felt while walking), 24 weeks of treatment with the angiotensin-converting enzyme (ACE) inhibitor ramipril was associated with improvement in pain-free and maximum walking times and the physical health aspect of quality of life, according to a study appearing in the February 6 issue of JAMA.

Related Articles


"Approximately 27 million individuals in Europe and North America have peripheral artery disease (PAD). Intermittent claudication occurs in approximately one-third of patients with PAD and typically presents as pain within leg muscle groups that occurs during walking but is relieved by rest. Patients with intermittent claudication have significant impairment in ambulatory function, resulting in functional disability and significant lifestyle limitation. Treatment of these patients is aimed at reducing cardiovascular risk, increasing functional performance, and improving health-related quality of life," according to background information in the article. Current drug treatments to improve walking distance have limited efficacy. A pilot trial with ramipril showed promising results. However, that trial was small and the findings were restricted to a subset of patients who comprise approximately one-half of all patients with claudication.

Anna A. Ahimastos, Ph.D., of the Baker IDI Heart and Diabetes Institute, Melbourne, Australia, and colleagues conducted a study to examine the association of ramipril therapy on walking distance and health-related quality of life as compared with placebo in a larger, more general PAD population. The randomized, placebo-controlled trial included 212 patients with peripheral artery disease (average age, 65.5 years), initiated in May 2008 and completed in August 2011. Patients were randomized to receive 10 mg/d of ramipril (n = 106) or matching placebo (n = 106) for 24 weeks. The primary outcome measures for the study were maximum and pain-free walking times, as recorded during a standard treadmill test. The Walking Impairment Questionnaire (WIQ) and Short-Form 36 Health Survey (SF-36) were used to assess walking ability and quality of life, respectively.

The researchers found that relative to placebo, ramipril was associated with a 75-second increase in average pain-free walking time and a 255-second increase in maximum walking time (a 77 percent and 123 percent increase in pain-free and maximum walking times, respectively). Compared to placebo, ramipril was also associated with improvements in WIQ scores (median distance, speed score and stair climbing) and the overall SF-36 median Physical Component Summary score.

"The increase in WIQ scores suggests that ramipril improves patient-perceived ability to perform normal daily activities. Ramipril therapy was also associated with moderate improvement in the physical health component of the SF-36 score. Importantly, these associations were additional to those achieved with standard clinical management by a general practitioner or vascular specialist. Further benefits may be achieved by adherence to lifestyle recommendations including smoking cessation and regular exercise, as well as more aggressive medical management of cardiovascular risk factors," the authors write.

"To our knowledge, this is the first adequately powered randomized trial demonstrating that treatment with ramipril is associated with improved treadmill walking performance in patients with PAD."

Editorial: Medications for Improving Walking Performance in Peripheral Artery Disease -- Still Miles to Go

Mary McGrae McDermott, M.D., of the Northwestern University Feinberg School of Medicine, Chicago, (also Contributing Editor, JAMA) comments on the results of this study in an accompanying editorial.

"A recent report from the Global Disease Burden study concluded that global disease burden continues to shift away from communicable to noncommunicable diseases and from premature death to greater years lived with disability. New therapies are needed to improve mobility and reduce disability among men and women living with PAD and other chronic diseases. Further study is needed to confirm the findings reported by Ahimastos et al and to determine whether ramipril therapy and other ACE inhibitors improve walking performance in ethnically diverse populations."


Story Source:

The above story is based on materials provided by American Medical Association (AMA). Note: Materials may be edited for content and length.


Journal References:

  1. Ahimastos AA, Walker PJ, Askew C, et al. Effect of Ramipril on Walking Times and Quality of Life Among Patients With Peripheral Artery Disease and Intermittent Claudication: A Randomized Controlled Trial. JAMA, 2013; 309 (5): 453-460 DOI: 10.1001/jama.2012.216237
  2. McDermott M. Medications for Improving Walking Performance in Peripheral Artery Disease: Still Miles to Go. JAMA, 2013; 309 (5): 487-488 DOI: 10.1001/jama.2013.89

Cite This Page:

American Medical Association (AMA). "ACE inhibitor for PAD may improve pain-free walking." ScienceDaily. ScienceDaily, 5 February 2013. <www.sciencedaily.com/releases/2013/02/130205162117.htm>.
American Medical Association (AMA). (2013, February 5). ACE inhibitor for PAD may improve pain-free walking. ScienceDaily. Retrieved March 6, 2015 from www.sciencedaily.com/releases/2013/02/130205162117.htm
American Medical Association (AMA). "ACE inhibitor for PAD may improve pain-free walking." ScienceDaily. www.sciencedaily.com/releases/2013/02/130205162117.htm (accessed March 6, 2015).

Share This


More From ScienceDaily



More Health & Medicine News

Friday, March 6, 2015

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Bupa Eyes India Healthcare Opportunities

Bupa Eyes India Healthcare Opportunities

Reuters - Business Video Online (Mar. 5, 2015) Bupa is hoping to expand in India&apos;s fast-growing health insurance market, once a rule change on foreign investment is implemented. The British private healthcare group&apos;s CEO tells Grace Pascoe why it&apos;s so keen on the new opportunity. Video provided by Reuters
Powered by NewsLook.com
Liberia Releases Last Ebola Patient, But Threat Remains

Liberia Releases Last Ebola Patient, But Threat Remains

Newsy (Mar. 5, 2015) Liberia&apos;s last Ebola patient has been released, and the country hasn&apos;t recorded a new case in a week. However, fears of another outbreak still exist. Video provided by Newsy
Powered by NewsLook.com
Doctor in Your Pocket Is Getting Smarter

Doctor in Your Pocket Is Getting Smarter

Reuters - Business Video Online (Mar. 5, 2015) Mobile apps are turning smartphones into a personal doctors, with users able to measure heart rate, blood pressure and even blood sugar. But will it change our behaviour? Ivor Bennett reports from the Mobile World Congress in Barcelona. Video provided by Reuters
Powered by NewsLook.com
AbbVie Inks $21B Deal To Buy Cancer Drugmaker Pharmacyclics

AbbVie Inks $21B Deal To Buy Cancer Drugmaker Pharmacyclics

Newsy (Mar. 5, 2015) AbbVie announced Wednesday it will buy cancer drugmaker Pharmacyclics in a $21 billion deal. Video provided by Newsy
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:

Strange & Offbeat Stories


Health & Medicine

Mind & Brain

Living & Well

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins