Ramipril: prevention of heart attack

Ramipril prevention of heart attack

Ramipril belongs to the drug class of ACE inhibitors (angiotensin converting enzyme) and is used as an antihypertensive drug to treat arterial  hypertension  . Ramipril is also used to prevent heart attacks and other cardiac diseases, such as  heart failure  . Although high blood pressure can be successfully treated with the active ingredient ramipril, it is not suitable for everyone due to the possible side effects. The dosage of ramipril is determined individually by the doctor.

effect of ramipril

Blood pressure is constantly adjusted to the needs of the body. During stress or physical exertion, the hormone angiotensin II is formed, which constricts the blood vessels and thus increases blood pressure. In addition, angiotensin II stimulates the production of the blood pressure-increasing hormone aldosterone. The active ingredient ramilpril inhibits the angiotensin converting enzyme (ACE), a protein that is responsible for the formation of angiotensin II. Therefore, less angiotensin-II is formed with ramilpril, causing the blood vessels to dilate and blood pressure to drop. This also relieves the heart, as it has to pump blood against a lower resistance.

In addition, due to the lower amount of angiotensin II, less aldosterone is released. This hormone ensures that less water is excreted in the body via the kidneys, which increases blood volume and thus blood pressure. Ramipril has an additional antihypertensive effect due to the reduced production of aldosterone. Since high blood pressure is one of the main risk factors for the development of arteriosclerosis, ramipril can protect against serious secondary diseases such as stroke, angina pectoris,  heart attack  and other diseases of the cardiovascular system.

possible side effects

Ramipril can cause various side effects, which can vary depending on the dosage, duration, frequency of use and dosage form of the active ingredient. Common side effects  of ramipril include:

  • visual disturbances
  • faintness or dizziness
  • renal dysfunction
  • Bronchitis or a dry, hacking cough
  • Disorders of the digestive tract and nausea
  • headache
  • lack of concentration
  • Tiredness or increased need for sleep

The occasionally occurring side effects of ramipril include skin reactions such as  hives  and exanthema or itching, shortness of breath, asthma attacks,  sore throat  and hoarseness. The concentration of the red blood pigment can be reduced. The blood composition can also change. Occasionally, a sudden drop in blood pressure is one of the side effects.

Rare side effects of ramipril include fainting, inflammation of the nasal mucosa, reduction in kidney function, vascular swelling and shock. Patients should rule out possible risk factors before taking ramipril and read the package insert.

Dosage and Interaction

The dosage of ramipril must always be individually tailored to the patient by the doctor. This is especially true if other medications are also taken, since an incorrect dosage of ramipril combined with the use of certain medications can cause serious interactions or side effects. This is the case, for example, with certain forms of therapy for  diabetes , lithium and certain medications for  gout , rheumatism,  cardiac arrhythmias  and cell growth disorders.

When choosing the right dosage of ramipril, it should also be noted that the active ingredient has a stronger effect in older people – since the effect of alcohol is stronger, it should be avoided while taking ramipril. Ramipril should not be taken during pregnancy as there is a risk of severe birth defects and stillbirths. If ramipril is combined with another active ingredient, such as HCT (hydrochlorothiazide), the dosage must be carefully coordinated.

Ramipril: contraindications and alternatives

The active ingredient ramipril should not be taken by children and adolescents under the age of 18. It is also unsuitable for people with narrowing of the renal arteries and heart valves and severe functional disorders of the kidneys and liver. Furthermore, ramipril must not be used in hyperaldosteronism (excessive production of the hormone aldosterone). Due to the possible side effects of antihypertensive drugs, it is always necessary to decide specifically in each individual case which drug is the most suitable.

An alternative to ACE inhibitors are so-called  AT1 antagonists . These active ingredients block a special “docking point” (receptor) of angiotensin II, through which the hormone achieves the vasoconstrictive effect. Angiotensin-II is therefore still formed, only the blood pressure-increasing effect is missing. Certain side effects such as a dry cough or shortness of breath, which can occur when taking ACE inhibitors, occur less frequently. All drugs that work by blocking the AT1 receptors have the suffix “-sartan” in the active ingredient name, such as telmisartan.

In addition to ACE inhibitors and AT1 antagonists, there are also antihypertensive drugs that work in other ways, such as the beta-blockers metoprolol and bisoprolol, or the calcium channel blocker  amlodipine . Drugs based on one of these active ingredients are also not free from side effects and contraindications and, like ramipril, can cause interactions with other drugs.

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