{"id":34529,"date":"2013-02-05T16:00:25","date_gmt":"2013-02-05T21:00:25","guid":{"rendered":"http:\/\/blogs.nejm.org\/cardioexchange\/?post_type=news&#038;p=34529"},"modified":"2013-02-05T16:18:23","modified_gmt":"2013-02-05T21:18:23","slug":"ace-inhibitor-improves-walking-in-people-with-peripheral-artery-disease","status":"publish","type":"post","link":"https:\/\/blogs.nejm.org\/cardioexchange\/2013\/02\/05\/ace-inhibitor-improves-walking-in-people-with-peripheral-artery-disease\/","title":{"rendered":"ACE Inhibitor Improves Walking in People with Peripheral Artery Disease"},"content":{"rendered":"<p>Giving an\u00a0ACE\u00a0inhibitor to people with peripheral artery disease (PAD) and intermittent claudication\u00a0reduces pain and increases walking time, according to a new study published in\u00a0<em>JAMA<\/em>. Currently the pharmacologic options for this patient population are few and have limited efficacy.<\/p>\n<p>Researchers at three Australian hospitals randomized 212 patients with PAD to receive the\u00a0ACE\u00a0inhibitor ramipril or placebo for 24 weeks. Compared to the patients on placebo, patients on the\u00a0ACE\u00a0inhibitor had a mean 75-second increase in their pain-free walking time (156 seconds in the placebo group versus 229 seconds in the ramipril group, p&lt;0.001) and a 255-second increase in their maximum walking time (259 seconds in the placebo group versus 512 seconds in the ramipril group, p&lt;0.001). \u00a0The\u00a0ACE\u00a0inhibitor was also associated with improvements in other secondary measures of walking and physical quality of life.<\/p>\n<p>The authors note that although the\u00a0<a href=\"http:\/\/www.nejm.org\/doi\/full\/10.1056\/NEJM200001203420301\">HOPE<\/a>\u00a0trial demonstrated that ramipril reduces cardiovascular events in PAD patients,\u00a0ACE\u00a0inhibitors are not &#8220;specifically recommended for the relief of intermittent claudication. 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.&#8221;<\/p>\n<p>In an accompanying editorial,\u00a0Mary McGrae McDermott writes that &#8220;given the paucity of effective therapies for treating functional limitation in PAD and recent randomized controlled clinical trials that have failed to demonstrate improved walking performance in response to novel medical therapies in PAD, the magnitude of improvement associated with ramipril&#8230; is particularly notable.&#8221; But, she observes, the results may not apply to other\u00a0ACE\u00a0inhibitors, and ramipril may not have the same efficacy in other PAD patient populations.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Giving an\u00a0ACE\u00a0inhibitor to people with peripheral artery disease (PAD) and intermittent claudication\u00a0reduces pain and increases walking time, according to a new study published in\u00a0JAMA. Currently the pharmacologic options for this patient population are few and have limited efficacy. Researchers at three Australian hospitals randomized 212 patients with PAD to receive the\u00a0ACE\u00a0inhibitor ramipril or placebo for [&hellip;]<\/p>\n","protected":false},"author":196,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[7,16],"tags":[512,1664,592,1665],"class_list":["post-34529","post","type-post","status-publish","format-standard","hentry","category-prevention","category-vascular","tag-ace-inhibitors","tag-intermitten-claudication","tag-peripheral-artery-disease","tag-ramipril"],"_links":{"self":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/posts\/34529","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/users\/196"}],"replies":[{"embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/comments?post=34529"}],"version-history":[{"count":0,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/posts\/34529\/revisions"}],"wp:attachment":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/media?parent=34529"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/categories?post=34529"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/tags?post=34529"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}