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Ramipril Reduces C-reactive Protein and Endothelial Function: Presented at CCC

By Danny Kucharsky

MONTREAL, CANADA -- November 4, 2005 -- Ramipril reduces the levels of high sensitivity C-reactive protein (CRP) in a cohort of healthy subjects with low to medium cardiovascular risk but the difference is insignificant in comparison to placebo, a randomized, double-blind, placebo-controlled study has found.

The ACE inhibitor ramipril also did not augment endothelial function, said investigator Subodh Verma, MD, Cardiologist, Division of Cardiac Surgery, St. Michael's Hospital, Toronto, Canada, who presented the study here October 24^th at the Canadian Cardiovascular Congress (CCC) 2005.

The study evaluated the effects of short-term ramipril on reduction of C-reactive protein, as evidence has emerged that lowering CRP may also lower cardiovascular risk.

Subjects were aged 35 to 80 years, were free of cardiovascular disease and had baseline CRP greater than 2.0 mg/L. A total of 264 subjects were randomized, 132 to each group, to ramipril 10 mg daily or matching placebo. Patients were seen in clinic at baseline and at 2, 6 and 12 weeks.

Mean baseline CRP level was 3.21 mg/L among patients randomized to ramipril. At 6 weeks, CRP increased slightly in this group to 3.28 mg/L and decreased at 12 weeks to 3.04 mg/L. Overall, mean CRP level decreased by 14% in the ramipril group (P < .001).

In the placebo group, CRP was 3.75 mg/L at baseline, decreased to 3.30 mg/L at 6 weeks and increased to 3.56 mg/L at 12 weeks. The difference between the groups was not significant (P = .24).

Dr. Verma noted that the study was initially powered to detect a change in CRP of 15% with standard deviation of 50% in the placebo group. Given that it was powered to detect a larger difference as well as the variability of CRP in the control group, a much larger study should be conducted, she said.

The study was supported by an unrestricted research grant from Sanofi-Aventis Canada.


[Presentation title: The Effects of Ramipril on C-reactive Protein and Endothelial Function in Healthy Volunteers at Low to Intermediate Risk: a Randomized Controlled Study, Abstract 504]

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