Effect of ramipril on walking times and quality of life among patients with peripheral artery disease and intermittent claudication: A randomized controlled trial
Importance: Approximately one-third of patients with peripheral artery disease experience intermittent claudication, with consequent loss of quality of life. Objective: To determine the efficacy of ramipril for improving walking ability, patient-perceived walking performance, and quality of life in...
| Main Authors: | , , , , , , , , |
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| Format: | Journal Article |
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2013
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| Online Access: | http://hdl.handle.net/20.500.11937/48143 |
| _version_ | 1848758029309181952 |
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| author | Ahimastos, A. Walker, P. Askew, C. Leicht, A. Pappas, E. Blombery, P. Reid, Christopher Golledge, J. Kingwell, B. |
| author_facet | Ahimastos, A. Walker, P. Askew, C. Leicht, A. Pappas, E. Blombery, P. Reid, Christopher Golledge, J. Kingwell, B. |
| author_sort | Ahimastos, A. |
| building | Curtin Institutional Repository |
| collection | Online Access |
| description | Importance: Approximately one-third of patients with peripheral artery disease experience intermittent claudication, with consequent loss of quality of life. Objective: To determine the efficacy of ramipril for improving walking ability, patient-perceived walking performance, and quality of life in patients with claudication. Design, Setting, and Patients: Randomized, double-blind, placebo-controlled trial conducted among 212 patients with peripheral artery disease (mean age, 65.5 [SD, 6.2] years), initiated in May 2008 and completed in August 2011 and conducted at 3 hospitals in Australia. Intervention: Patients were randomized to receive 10 mg/d of ramipril (n=106) or matching placebo (n=106) for 24 weeks. Main Outcome Measures: Maximum and pain-free walking times were 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. Results: At 6 months, relative to placebo, ramipril was associated with a 75-second (95% CI, 60-89 seconds) increase in mean pain-free walking time (P<.001) and a 255-second (95% CI, 215-295 seconds) increase in maximum walking time (P<.001). Relative to placebo, ramipril improved the WIQ median distance score by 13.8 (Hodges-Lehmann 95% CI, 12.2-15.5), speed score by 13.3 (95% CI, 11.9-15.2), and stair climbing score by 25.2 (95% CI, 25.1-29.4) (P<.001 for all). The overall SF-36 median Physical Component Summary score improved by 8.2 (Hodges-Lehmann 95% CI, 3.6-11.4; P=.02) in the ramipril group relative to placebo. Ramipril did not affect the overall SF-36 median Mental Component Summary score. Conclusions and Relevance: Among patients with intermittent claudication, 24-week treatment with ramipril resulted in significant increases in pain-free and maximum treadmill walking times compared with placebo. This was associated with a significant increase in the physical functioning component of the SF-36 score. Trial Registration: clinicaltrials.gov Identifier: NCT00681226 ©2013 American Medical Association. All rights reserved. |
| first_indexed | 2025-11-14T09:37:29Z |
| format | Journal Article |
| id | curtin-20.500.11937-48143 |
| institution | Curtin University Malaysia |
| institution_category | Local University |
| last_indexed | 2025-11-14T09:37:29Z |
| publishDate | 2013 |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | curtin-20.500.11937-481432017-09-13T14:22:51Z Effect of ramipril on walking times and quality of life among patients with peripheral artery disease and intermittent claudication: A randomized controlled trial Ahimastos, A. Walker, P. Askew, C. Leicht, A. Pappas, E. Blombery, P. Reid, Christopher Golledge, J. Kingwell, B. Importance: Approximately one-third of patients with peripheral artery disease experience intermittent claudication, with consequent loss of quality of life. Objective: To determine the efficacy of ramipril for improving walking ability, patient-perceived walking performance, and quality of life in patients with claudication. Design, Setting, and Patients: Randomized, double-blind, placebo-controlled trial conducted among 212 patients with peripheral artery disease (mean age, 65.5 [SD, 6.2] years), initiated in May 2008 and completed in August 2011 and conducted at 3 hospitals in Australia. Intervention: Patients were randomized to receive 10 mg/d of ramipril (n=106) or matching placebo (n=106) for 24 weeks. Main Outcome Measures: Maximum and pain-free walking times were 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. Results: At 6 months, relative to placebo, ramipril was associated with a 75-second (95% CI, 60-89 seconds) increase in mean pain-free walking time (P<.001) and a 255-second (95% CI, 215-295 seconds) increase in maximum walking time (P<.001). Relative to placebo, ramipril improved the WIQ median distance score by 13.8 (Hodges-Lehmann 95% CI, 12.2-15.5), speed score by 13.3 (95% CI, 11.9-15.2), and stair climbing score by 25.2 (95% CI, 25.1-29.4) (P<.001 for all). The overall SF-36 median Physical Component Summary score improved by 8.2 (Hodges-Lehmann 95% CI, 3.6-11.4; P=.02) in the ramipril group relative to placebo. Ramipril did not affect the overall SF-36 median Mental Component Summary score. Conclusions and Relevance: Among patients with intermittent claudication, 24-week treatment with ramipril resulted in significant increases in pain-free and maximum treadmill walking times compared with placebo. This was associated with a significant increase in the physical functioning component of the SF-36 score. Trial Registration: clinicaltrials.gov Identifier: NCT00681226 ©2013 American Medical Association. All rights reserved. 2013 Journal Article http://hdl.handle.net/20.500.11937/48143 10.1001/jama.2012.216237 unknown |
| spellingShingle | Ahimastos, A. Walker, P. Askew, C. Leicht, A. Pappas, E. Blombery, P. Reid, Christopher Golledge, J. Kingwell, B. Effect of ramipril on walking times and quality of life among patients with peripheral artery disease and intermittent claudication: A randomized controlled trial |
| title | Effect of ramipril on walking times and quality of life among patients with peripheral artery disease and intermittent claudication: A randomized controlled trial |
| title_full | Effect of ramipril on walking times and quality of life among patients with peripheral artery disease and intermittent claudication: A randomized controlled trial |
| title_fullStr | Effect of ramipril on walking times and quality of life among patients with peripheral artery disease and intermittent claudication: A randomized controlled trial |
| title_full_unstemmed | Effect of ramipril on walking times and quality of life among patients with peripheral artery disease and intermittent claudication: A randomized controlled trial |
| title_short | Effect of ramipril on walking times and quality of life among patients with peripheral artery disease and intermittent claudication: A randomized controlled trial |
| title_sort | effect of ramipril on walking times and quality of life among patients with peripheral artery disease and intermittent claudication: a randomized controlled trial |
| url | http://hdl.handle.net/20.500.11937/48143 |