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Amlodipine and ramipril attenuate exercise-induced rise of systolic blood pressure in hypertensive patients

Mahendra Kumar Chhabra, Rachna Gupta, Rajnish Avasthi, Krishna Kishore Sharma, Lalit Kumar Gupta.




Abstract

Objective: To evaluate the effects of ramipril and amlodipine on treadmill exercise-induced changes in blood pressure (BP) in patients with mild to moderate hypertension.
Methods: Subjects with mild to moderate hypertension were randomly assigned to any of the three groups; amlodipine, ramipril or placebo, once daily. The maintenance dose of the drugs were administered for 8 weeks. Resting systolic BP (SBP), diastolic BP (DBP) and heart rate (HR) were measured before and after the drug administration. Treadmill test (TMT) was performed according to extended Bruce protocol, before and after 8 weeks of drug treatment. For TMT the basal parameters (SBP, DBP and HR) were recorded in the standing position, at the end of each stage till the target heart rate was achieved.
Results: Treadmill exercise caused a rise in SBP in the untreated patients in all the groups. Amlodipine and ramipril groups showed a significant fall in the resting SBP and DBP and post-exercise standing SBP in comparison to their respective pre-treatment values while it was statistically insignificant with placebo. Also, there was no significant effect on the mean resting HR while pre-exercise and post-exercise standing HR significantly increased in amlodipine and ramipril groups in comparison to their respective pre-treatment values.
Conclusion: This study shows that amlodipine and ramipril treatment in mild to moderate hypertension decrease BP (at rest) and cause attenuation of the rise in SBP induced by exercise. The use of amlodipine and ramipril in patients with mild to moderate hypertension could decrease the risk of developing left ventricular hypertrophy by decreasing BP at rest and during exercise.

Key words: Amlodipine; Exercise-induced hypertension; Ramipril






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