Clinical efficacy of losartan and ramipril in male patients with hypertension depending on age, uricemia level, and hypertension type

  • V.P. Ivanov The M.I. Pyrohov National Medical University in Vinnytsia, Ukraine
  • T.M. Kostrubska Military Hospital, Lutsk
  • O.V. Kovalchuk The M.I. Pyrohov National Medical University in Vinnytsia, Ukraine
Keywords: antihypertensive therapy, elderly male patients, Losartan, Ramipril


Aim. Aging of population, treatment of cardiovascular diseases in the context of higher longevity, and improving the quality of life are considered among relevant problems of modern medicine. The purpose of our study was to evaluate clinical efficacy of Losartan and Ramipril in men with hypertension (HT), depending on their age, level of uricemia and HT type.

Materials and Methods. We examined 90 elderly men of the average age of 72.5 years with Grade II hypertension. Most patients had high (54.4%) and very high (22.2%) cardiovascular risk. 69.5% of examined patients were senior males and 30.5% - elderly males. More than half (62.2%) of the patients were diagnosed with moderate AH (HT Grade II). 27.8% patients had severe AH (Grade III HT) and only 10.0% were mild (Grade I HT) cases. The largest portion (50.0%) were patients with a 10- to 20-year history of AH, and the smallest one (8.9%) - with  over 20-year history of the disease. All patients were prescribed standard Losartan therapy or Ramipril in combination with Indapamidum, Amlodipinum and Doxazosin, if blood pressure control was needed. Apart from antihypertensive drugs, all patients were prescribed a daily dose of 75 mg acetylsalicylic acid and Rozuvastatinum at a dose of 10-20 mg per day. The dose of the latter was selected against the controlled value of LDL cholesterol with a target level <2.5 mmol/L. Follow-up lasted for 6 months. The therapy efficacy control was carried out using daily monitoring of blood pressure. A package of  specialized program applications was used for the statistical analysis [8, 9].

Results and Discussions. As a result, administration of Ramipril, Indapamidum and Amlodipinum combination in the given group of patients demonstrated less antihypertensive efficacy compared with the group where Losartan, Indapamidum and Amlodipinum were administered (84.4% and 95.6%, accordingly). We used the Patient Impression Scale, which demonstrated almost equal tolerability of treatment in both Ramipril and Losartan groups (4.78 and 6.0 points, respectively). We also studied the efficacy of antihypertensive therapy in patients with hyperuricemia and isolated systolic hypertension.

Conclusions. Six months of treatment revealed better antihypertensive efficacy of the Losartan + Indapamidum combination compared with the Ramipril + Indapamidum combination (62.2% and 46.7%, accordingly). Adding Amlodipinum to the regimen resulted in better antihypertensive efficacy of the combinations (95.6% to 84.4%, respectively). Ramipril was discontinued in 8.2% of patients and Amlodipinum - in 14.6% due to side effects. Ramipril appeared to deliver more antihypertensive efficacy in senior patients, whilst the effect of Losartan was independent of age. Hyperuricemia (HU) and isolated systolic hypertension (ISHT) resulted in lower antihypertensive efficacy of both Ramipril and Losartan.


Decree of the MOH of Ukraine of 24.05.12 p. №384. On approval of implementation of medical and technological documents for standardization of medical care in hypertension. Avaliable at:

Mancia G., Fagard R.,Narkiewicz K., Redon J., Zanchetti A. (2013) 2013 ESH/ESC Guidelines for the management of arterial hypertension. Journal of Hypertension, vol. 31, pp. 1281-1357.

Aronow W.S., Fleg J.L., Pepine C.J., Artinian N.T., Bakris G., Brown A.S., Ferdinand K.C., Ann Forciea M., Frishman W.H., Jaigobin C., Kostis J., Mancia G., Oparil S., Ortiz E., Reisin E., Rich M.W., Schocken D.D., Weber M.A., Wesley D.J. (2011) ACCF/AHA 2011 expert consensus document of hypertension in the elderly: a report of American College of Cardiology Foundation Task Force on Clinical Expert Consensus documents developed in collaboration with the American Academy of Neurology, American Geriatrics Society, American Society for Preventive Cardiology, American Society of Hypertension, American Society of Nephrology, Association of Black Cardiologists, and European Society of Hypertension. Journal of the American College of Cardiology, vol. 57, pp. 2037-2114.

Dahlof B., Devereux R.B., Kjeldsen S.E., Julius S., Beevers G., de Faire U., Fyhrquist F., Ibsen H., Kristiansson K., Lederballe- Pedersen O., Lindholm L.H., Nieminen M.S., Omvik P., Oparil S., Wedel H. (2002) Cardiovascular morbidity and mortality in the Losartan Intervention For Endpoint reduction in hypertension study (LIFE): a randomized trial against atenolol. Lancet, vol. 359, pp.995-1003.

Kassler-Taub K., Littlejohn T., Elliott W., Ruddy T., Adler E. (1998) Comparative efficacy of two angiotensin II receptor antagonists, irbesartan and losartan, in mild to moderate hypertension. American Journal of Hypertension, vol. 11, pp. 445-453.

Parati G., Stergiou G.S., Asmar R. Et al. (2008) ESH Working Group on Blood Pressure Monitoring. European Society of Hypertension guidelines for blood pressure monitoring at home: a summary report of the Second International Consensus Conference on Home Blood Pressure Monitoring. J. Hypertens, vol. 26, pp. 1505-1526.

EULAR evidence based recommendations for gout. Part II: Management. Report of a task force of the EULAR Standing Committee For International Clinical Studies Including Therapeutics (ESCISIT) / W. Zhang et al. Ann. Rheum. Dis. 2006.V.65.P. 1312-1324.

Yu.O. Rebrova. Statistical analysis of medical data. Application of STATISTICA software packages. - M. Mediasphere, 2006.312s.-3rd Edition.

Lapach SN Chubenko AV Babich PN Statistical methods in biomedical research using Excel.- K.: MORION, 2000.320.

How to Cite
Ivanov, V., Kostrubska, T., & Kovalchuk, O. (2016). Clinical efficacy of losartan and ramipril in male patients with hypertension depending on age, uricemia level, and hypertension type. Acta Medica Leopoliensia, 22(4), 19-26. Retrieved from