Difference between Lisinopril and Ramipril

Combined primary outcome of myocardial infarction, stroke
or cardiovascular death reduced by 25%, (ramipril 15.3%
versus 19.8% placebo).

Myocardial infarction reduced 22%, (ramipril 10.2% versus
12.9% placebo).

Stroke reduced 33%, (ramipril 4.2% versus 6.1% placebo).

Cardiovascular death reduced 37%, (ramipril 6.2% versus
placebo 9.7%).

Secondary outcomes
 Total mortality reduced 24%
 Revascularisation reduced 17%
 Overt nephropathy reduced 24%
 Overt nephropathy, laser, therapy or dialysis reduced 16%.

Other outcomes
 Any heart failure reduced 20%.
Transient ischaemic attacks reduced 26%.
Worsening angina reduced 13%, (p=0.057).

The benefit of ramipril was noted irrespective of whether
subjects had a history of previous cardiovascular events,
hypertension or microalbuminuria, or whether the patients
had type 1 or 2 diabetes. At the end of the study there is no
significant difference in HbA1C% values.

Blood pressure difference was 2.47/1.00 in favour of ramipril.
After adjustment and changes in blood pressure, ramipril had
the same effect on primary outcomes as before adjustment.

Vitamin E had no significant effect.

Treatment of 1,000 patients with ramipril for four years will
prevent about 150 events in approximately 70 patients.

Click to expand...