Approximately a third of patients with peripheral arterial disease (PAD) will develop intermittent claudication. \u00a0A previous pilot trial found that the angiotensin-converting enzyme inhibitor ramipril is associated with increased pain-free and maximum walking times, contrasting with previous ACE inhibitor studies which may have been limited by issues of small sample size, short intervention duration, and lack of a placebo group. \u00a0Therefore this trial was designed to investigate the effect of 24 weeks of ramipril therapy on walking distance and health-related quality of life as compared with placebo in a larger, more general PAD population including patients with diabetes and patients with aortoiliac and infrainguinal disease.<\/p>\n
212 patients with peripheral arterial disease were recruited from three Australian hospitals, and randomised to receive 10mg of ramipril daily, or placebo, for 24 weeks. \u00a0Maximum and pain-free walking times were recorded during a standard treadmill test. \u00a0The Walking Impairment Questionnaire (WIQ) and Short-Form 36 Health Survey (SF-36) were used to assess walking ability and quality of life, respectively.<\/p>\n
At six months, patients taking ramipril had a 75-second increase in pain-free walking time compared to those taking placebo (P<.001), and a 255-second increase in maximum walking time (P<.001). \u00a0WIQ and SF-36 scores also improved, although ramipril did not affect the overall SF-36 median Mental Component Summary score.<\/p>\n
Conclusions<\/strong>:<\/p>\n In patients with intermittent claudication, 24-week treatment with ramipril led to significant improvements in pain-free and maximum treadmill walking times, which was also associated with an increase in the physical functioning component of the SF-36 score.<\/p>\n