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PULMONARY EMBOLISM and Ramipril

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PULMONARY EMBOLISM Symptoms and Causes

What is a pulmonary embolism (PE)?

A pulmonary embolism (PE) is a sudden blockage in a lung artery. It usually happens when a when a blood clot breaks loose and travels through the bloodstream to the lungs. PE is a serious condition that can cause

  • Permanent damage to the lungs
  • Low oxygen levels in your blood
  • Damage to other organs in your body from not getting enough oxygen

PE can be life-threatening, especially if a clot is large, or if there are many clots.

What causes a pulmonary embolism (PE)?

The cause is usually a blood clot in the leg called a deep vein thrombosis that breaks loose and travels through the bloodstream to the lung.

Who is at risk for a pulmonary embolism (PE)?

Anyone can get a pulmonary embolism (PE), but certain things can raise your risk of PE:

  • Having surgery, especially joint replacement surgery
  • Certain medical conditions, including
    • Cancers
    • Heart diseases
    • Lung diseases
    • A broken hip or leg bone or other trauma
  • Hormone-based medicines, such as birth control pills or hormone replacement therapy
  • Pregnancy and childbirth. The risk is highest for about six weeks after childbirth.
  • Not moving for long periods, such as being on bed rest, having a cast, or taking a long plane flight
  • Age. Your risk increases as you get older, especially after age 40.
  • Family history and genetics. Certain genetic changes that can increase your risk of blood clots and PE.
  • Obesity
What are the symptoms of a pulmonary embolism (PE)?

Half the people who have pulmonary embolism have no symptoms. If you do have symptoms, they can include shortness of breath, chest pain or coughing up blood. Symptoms of a blood clot include warmth, swelling, pain, tenderness and redness of the leg.

How is a pulmonary embolism (PE) diagnosed?

It can be difficult to diagnose PE. To make a diagnosis, your health care provider will

  • Take your medical history, including asking about your symptoms and risk factors for PE
  • Do a physical exam
  • Run some tests, including various imaging tests and possibly some blood tests
What are the treatments for a pulmonary embolism (PE)?

If you have PE, you need medical treatment right away. The goal of treatment is to break up clots and help keep other clots from forming. Treatment options include medicines and procedures.

Medicines

  • Anticoagulants, or blood thinners, keep blood clots from getting larger and stop new clots from forming. You might get them as an injection, a pill, or through an I.V. (intravenous). They can cause bleeding, especially if you are taking other medicines that also thin your blood, such as aspirin.
  • Thrombolytics are medicines to dissolve blood clots. You may get them if you have large clots that cause severe symptoms or other serious complications. Thrombolytics can cause sudden bleeding, so they are used if your PE is serious and may be life-threatening.

Procedures

  • Catheter-assisted thrombus removal uses a flexible tube to reach a blood clot in your lung. Your health care provider can insert a tool in the tube to break up the clot or to deliver medicine through the tube. Usually you will get medicine to put you to sleep for this procedure.
  • A vena cava filter may be used in some people who cannot take blood thinners. Your health care provider inserts a filter inside a large vein called the vena cava. The filter catches blood clots before they travel to the lungs, which prevents pulmonary embolism. But the filter does not stop new blood clots from forming.
Can pulmonary embolism (PE) be prevented?

Preventing new blood clots can prevent PE. Prevention may include

  • Continuing to take blood thinners. It's also important to get regular checkups with your provider, to make sure that the dosage of your medicines is working to prevent blood clots but not causing bleeding.
  • Heart-healthy lifestyle changes, such as heart-healthy eating, exercise, and, if you smoke, quitting smoking
  • Using compression stockings to prevent deep vein thrombosis (DVT)
  • Moving your legs when sitting for long periods of time (such as on long trips)
  • Moving around as soon as possible after surgery or being confined to a bed

NIH: National Heart, Lung, and Blood Institute

Check out the latest treatments for PULMONARY EMBOLISM

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Ramipril Side Effects

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PULMONARY EMBOLISM Clinical Trials and Studies

Treatments might be new drugs or new combinations of drugs, new surgical procedures or devices, or new ways to use existing treatments. The goal of clinical trials is to determine if a new test or treatment works and is safe. Clinical trials can also look at other aspects of care, such as improving the quality of life for people with chronic illnesses. People participate in clinical trials for a variety of reasons. Healthy volunteers say they participate to help others and to contribute to moving science forward. Participants with an illness or disease also participate to help others, but also to possibly receive the newest treatment and to have the additional care and attention from the clinical trial staff.
Rank Status Study
1 Recruiting Ramipril and Clopidogrel in Oxidative Stress, Vascular Inflammation and Endothelial Dysfunction in Type 2 Diabetes and Diabetic Nephropathy
Conditions: Diabetes Type 2;   Diabetic Nephropathy;   Vascular Disease
Interventions: Drug: Ramipril;   Drug: Clopidogrel
Outcome Measures: Changes in Asymmetric dimethylarginine (ADMA) blood levels after the combined treatment with Ramipril and clopidogrel compared with Ramipril monotherapy;   Changes in High-sensitivity C-reactive protein (HsCRP) blood levels after the combined treatment with Ramipril and clopidogrel compared with Ramipril monotherapy;   Changes in soluble CD40 Ligand (sCD40L)blood levels after the combined treatment with Ramipril and clopidogrel compared with Ramipril monotherapy;   Changes in urine 8-isoprostane-F2 levels after the combined treatment with Ramipril and clopidogrel compared with Ramipril monotherapy;   Reduction in albumine to creatine ratio after the combined treatment with Ramipril and clopidogrel compared with Ramipril monotherapy;   Changes in ADMA blood levels after treatment with Ramipril;   Increase of Glomerular Filtration Rate (GFR) after combined treatment with Ramipril and clopidogrel and after Ramipril monotherapy;   Change from baseline in carotid intima-media thickness after combined therapy with Ramipril and clopidogrel and after Ramipril monotherapy
2 Recruiting Mechanisms of Ramipril Reduction in the Onset of Type 2 Diabetes
Condition: Metabolic Syndrome
Interventions: Drug: Ramipril;   Drug: HCTZ-hydrochlorothiazide;   Drug: Ramipril+HCTZ
Outcome Measure: Changes in Insulin Sensitivity
3 Recruiting Ramipril for the Treatment of Oligospermia
Conditions: Oligospermia;   Teratospermia;   Asthenozoospermia;   Male Infertility
Interventions: Drug: Ramipril;   Drug: Placebo
Outcome Measures: Sperm density in infertile men with documented oligospermia.;   Total Motile Sperm Count(TMSC), total sperm count, sperm motility, and morphology in the ejaculate.;   Pregnancy rate;   Hormonal profile
4 Unknown  Clinical and Cost Effectiveness of ACE Inhibitor, Ramipril, in Intermittent Claudicants
Condition: Intermittent Claudicants
Intervention: Drug: Ramipril
Outcome Measures: The primary outcome measure for this trial is the Maximum Walking Distance (MWD). Treadmill exercise test will be used to estimate the maximum distance the participant can walk at a speed of 2.5 km/h with a 10 degree incline.;   Other clinical indicators of lower limb ischaemia: a) Patient Reported Walking Distance (PRWD) b) Treadmill Intermittent Claudication Distance (ICD) c) Ankle Brachial Pressure Index at rest (ABPI- r) and following treadmill testing (ABPI - t);   Quality of life: a) Generic - measured using the SF36, SF8 and EuroQol (EQ5D) instruments b) Disease specific - measured using the VascuQol;   Cardiovascular prognosis using: a) Framingham, PROCAM, QRISK and Manchester charts scoring systems b) B-type Natriuretic Peptide (BNP) and N- terminal prohormone BNP (NT-proBNP) and a Lipid profile ( LDL, HDL, Total Cholesterol, Triglycerides);   Markers of endothelial function and ischaemia reperfusion a) IL6 b) soluble Intercellular Adhesion Molecule-1 (sICAM -1) c) sE selectin d) Urine Albumin Creatinine Ratio ( UACR);   Arterial effects: a) Arterial stiffness by measuring the Pulse Wave Velocity and assessing the effects on the extracellular matrix by measuring Metalloproteinases (MMPs) and Tissue Inhibitor Metalloproteinases (TIMPs). b) Flow mediated vasodilatation;   Health economics (cost effectiveness / utility)
5 Unknown  Left Atrial Remodelling in Hypertension: Effects of Ramipril or Irbesartan
Conditions: Left Atrial Volume;   Hypertensive Heart Disease;   Antihypertensive Drugs;   Diastolic Function;   Renin Angiotensin System
Interventions: Drug: Ramipril;   Drug: irbesartan
Outcome Measures: left atrial volume;   diastolic function;   systolic and diastolic blood pressure
6 Unknown  Antiproteinuric Effect of Imidapril Versus Ramipril in Type 2 Diabetic and Hypertensive Patients With Microalbuminuria
Conditions: Hypertension;   Type 2 Diabetes Mellitus;   Microalbuminuria
Interventions: Drug: Ramipril;   Drug: Imidapril
Outcome Measures: Size of the reduction of urinary albumin in 24 hours to the various controls;   1. Size of the reduction of mean 24-hour average daytime and nighttime average. 2. Size of the reduction of central blood pressure. 3. Magnitude of changes in plasma concentrations of angiotensin II, bradykinin and BNP after 24 weeks of treatment.
7 Not yet recruiting Aliskiren Study of Safety and Efficacy in Senior Hypertensives
Condition: Hypertension
Interventions: Drug: Aliskiren;   Drug: Amlodipine;   Drug: Ramipril;   Drug: Hydrochlorothiazide
Outcome Measures: Change from baseline in mean sitting systolic blood pressure (MSSBP) to week 8;   Number of patients with serious adverse events and adverse events;   Number of patients with hyperkalemia, hypotension and reduction of estimated glomerular filtration rate (eGFR);   Change from baseline in mean sitting systolic blood pressure (MSSBP) at the end of double blind period;   Percentage of patients achieving blood pressure control;   Percentage of patients with major cardiovascular events;   Number of patients with gastrointestinal tract cancer
8 Unknown  Ramipril Versus Carvedilol in Duchenne and Becker Patients
Conditions: Duchenne Muscular Dystrophy;   Becker Muscular Dystrophy
Interventions: Drug: carvedilol;   Drug: Ramipril
Outcome Measures: Left ventricular Ejection Fraction, systolic and diastolic left ventricular volumes and LGE (as a quantitative measure) detected by MRI and myocardial Ultrasound Tissue Characterisation data by Echocardiography.;   Prevalence of LGE in DMD and BMD patients,the effects of pharmacological therapy both on LGE evolution and myocardial UTC analysis.
9 Unknown  Aliskiren Versus Ramipril on Antiproteinuric Effect in Hypertensive, Type 2 Diabetic Patients With Microalbuminuria
Conditions: Hypertension;   Type 2 Diabetes
Interventions: Drug: Ramipril;   Drug: Experimental
Outcome Measures: Antiproteinuric effect as well as antihypertensive effect of aliskiren 300 mg / daily versus Ramipril 10 mg daily in hypertensive patients with type 2 diabetes and microalbuminuria.;   Average of 24 hours by ABPM, systolic and diastolic blood pressure;   Average daytime, systolic and diastolic blood pressure;   Average night, systolic and diastolic blood pressure
10 Recruiting Efficacy and Safety Study to Delay Renal Failure in Children With Alport Syndrome
Condition: Renal Insufficiency, Chronic
Interventions: Drug: Ramipril;   Drug: placebo to Ramipril
Outcome Measures: Time to next disease level;   Incidence of Adverse Drug Events before progression;   Albuminuria after three years;   Adverse Drug Events over three years
11 Unknown  Telmisartan Versus Ramipril After Acute Coronary Syndrome
Conditions: Acute Coronary Syndrome;   Myocardial Infarction;   Coronary Disease
Interventions: Drug: TELMISARTAN;   Drug: Ramipril
Outcome Measures: High sensitivity C-Reactive Protein;   Endothelial Progenitor Cells
12 Recruiting Impact of Body Composition on Bisoprolol and Ramipril Pharmacokinetics in Patients With Chronic Heart Failure
Conditions: Chronic Heart Failure;   Cachexia
Intervention:
Outcome Measures: Pharmacokinetic parameters of bisoprolol and Ramipril;   Body composition;   Cachexia diagnosis;   Renal function
13 Not yet recruiting Statin and Angiotensin-converting Enzyme Inhibitor on Symptoms in Patients With SCAD
Condition: Coronary Artery Dissection, Spontaneous
Interventions: Drug: Ramipril;   Drug: rosuvastatin;   Drug: placebo
Outcome Measures: Angina frequency domain of the SAQ;   Acute coronary syndrome or hospitalization for angina
14 Recruiting Sevelamer in Proteinuric CKD
Condition: Chronic Kidney Disease
Interventions: Drug: Sevelamer;   Drug: Ramipril and Irbesartan
Outcome Measures: 24-h urinary protein excretion;   Office blood pressure;   Glomerular Filtration Rate
15 Recruiting Genes, Fibrinolysis and Endothelial Dysfunction- Dialysis Aim 3
Conditions: Oxidative Stress;   Endothelial Dysfunction
Interventions: Drug: Ramipril (ACE inhibitor);   Drug: valsartan (ARB);   Drug: Placebo
Outcome Measures: To compare the long term effects of ACE inhibition or angiotensin receptor blockade versus placebo on biomarkers of fibrinolysis, oxidative stress and inflammation in patients with chronic kidney disease undergoing maintenance hemodialysis;   To compare the long term effects of ACE inhibition or AT1 receptor blockade versus placebo on carotid intima-media thickness (IMT) in patients with chronic kidney disease undergoing maintenance hemodialysis;   Track safety endpoints- hyperkalemia, hypotension, nonfatal myocardial infarction, nonfatal stroke, death from cardiac causes, fatal stroke, death due to any cause.
16 Unknown  Defining Strategies for Improving Endothelial and Fibrinolytic Dysfunction in Obesity
Condition: Metabolic Syndrome X
Interventions: Drug: Eplerenone;   Drug: Ramipril
Outcome Measures: Secreted factors from adipocytes have autocrine, paracrine and endocrine effects that have a deleterious effect on the fibrinolytic system, either by enhancing PAI-1 production or impairing endothelial t-PA release;   This study will analyze patients' genetic make up to identify who may be at greater risk for heart disease and strokes in relationship to high blood pressure and central obesity.
17 Not yet recruiting Cardiac Energetics and Function in Normal Human Ageing
Conditions: Left Ventricular Function Systolic Dysfunction;   Left Ventricular Function Diastolic Dysfunction;   Ageing
Intervention: Drug: Ramipril
Outcome Measures: Vascular Stiffness;   Left Ventricular Energetics;   Left Ventricular Function;   Effects of ACE inhibitor on left ventricular energetics and function in those subjects aged 40 and over
18 Not yet recruiting Effect of Chronic ACE and DPP4 Inhibition on Blood Pressure
Conditions: Type 2 Diabetes Mellitus;   Hypertension
Interventions: Drug: Placebo;   Drug: Sitagliptin;   Drug: Aprepitant
Outcome Measures: Blood pressure;   heart rate;   norepinephrine (NE) concentrations;   Low frequency variability of blood pressureactivity, aldosterone;   glucose;   insulin;   DPP4 activity;   ACE
19 Recruiting Prevention of Atrial Fibrillation by Inhibition Conversion Enzyme (ICE) After Radiofrequency Ablation of Atrial Flutter
Conditions: Atrial Fibrillation;   Atrial Flutter
Interventions: Drug: Ramipril;   Drug: Placebo
Outcome Measures: At least one relevant symptomatic or asymptomatic atrial fibrillation event;   All relevant cardiovascular event;   Secondary effects of the treatment
20 Recruiting Fixed Dose Combination Drug (Polypill)for Secondary Cardiovascular Prevention.
Condition: Myocardial Infarction
Interventions: Drug: FDC;   Drug: Separately drugs, simvastatin, aspirin and Ramipril
Outcome Measures: Proportion of patients receiving AAS, an ACE inhibitor and a statin among those without contraindications to any of these drugs Adherence to treatment measured by: Morinsky-Green test and Pill accountability.;   Adherence to treatment measured by the Morisky-Green questionnaire;   Treatment adherence measured by: Morisky-Green test: (Good adherence score 16-20) at 1 and 9 months.;   Treatment adherence measured by: Pill counts at 1-4-9 months. (Good adherence 80-110% PC);   Blood Pressure and Lipid Profile (LDL-cholesterol) at 1 and 9 months;   Safety and tolerability: Adverse events and rate of treatment withdrawal.