Chronopharmacological Study Of Angiotensin-Converting Enzyme Inhibitor Ramipril In Hypertensive Patients In A Hospital: Analysis Of Efficacy And Tolerability Based On Administration Time Variations

Authors

  • Fendy Prasetyawan Progdi Pendidikan Profesi Apoteker, Fakultas Ilmu Kesehatan, Universitas Kadiri, Kediri, Indonesia
  • Faisal Akhmal Muslikh Progdi Farmasi, Fakultas Farmasi, Institut Ilmu Kesehatan Bhakti Wiyata, Kediri, Indonesia
  • Yuneka Saristiana Progdi Pendidikan Profesi Apoteker, Fakultas Ilmu Kesehatan, Universitas Kadiri, Kediri, Indonesia
  • Ratna Mildawati Progdi Farmasi, STIKes Ganesha Husada, Kediri, Indonesia
  • Chandra Arifin Progdi Farmasi, Akademi Kesehatan Arga Husada, Kediri, Indonesia
  • Abd Rofiq Progdi Farmasi, Akademi Kesehatan Arga Husada, Kediri, Indonesia
  • Dewi Retno Puspitosari Progdi Keperawatan, STIKes Ganesha Husada, Kediri, Indonesia

DOI:

https://doi.org/10.58471/esaprom.v3i02.4752

Keywords:

Chronopharmacology, Ramipril, Hypertension, Zeitgeber, Blood Pressure

Abstract

This research investigates the chronopharmacological effects of Ramipril administration on hypertensive patients, focusing on the timing of drug intake. Studies conducted by Firli Choerun Nisa and Siti Rohmiati in 2022 provide the basis for this analysis. Using observational-analytic methods with cross-sectional designs, data were collected prospectively from 23 patients in each study. Firli Choerun Nisa's study at RSUD Singaparna Medika Citrautama, Tasikmalaya Regency, involved 14 patients in the light zeitgeber group and 9 in the dark zeitgeber group. Results indicated significant reductions in both systolic and diastolic blood pressures, with the dark zeitgeber group experiencing more substantial decreases. The SPSS analysis showed a p-value of 0.062, indicating no statistically significant difference between the groups. Siti Rohmiati's study at RSUD Dr. Soekardjo Tasikmalaya found similar results. The light zeitgeber group showed a systolic decrease of 9.9 mmHg and a diastolic decrease of 5 mmHg, while the dark zeitgeber group had decreases of 16.66 mmHg and 10.56 mmHg, respectively. The SPSS analysis also yielded a p-value of 0.062, supporting the conclusion of no significant difference in Ramipril's efficacy based on administration timing. The comprehensive analyses revealed that Ramipril effectively reduces blood pressure regardless of the administration time. Significant reductions in both the daytime and nighttime groups were noted, with trends suggesting a more pronounced effect during nighttime administration. These findings emphasize the importance of flexibility in medication timing, enhancing patient adherence without compromising therapeutic outcomes. In conclusion, the timing of Ramipril administration, whether in the morning or evening, does not significantly impact its effectiveness in managing hypertension. This flexibility offers practical benefits for clinical practice, supporting better patient adherence and optimized hypertension management. These studies contribute to the broader understanding of chronopharmacology, providing insights for improved treatment strategies in hypertensive care.

References

Ahmad, H., Khan, H., Haque, S., Ahmad, S., Srivastava, N., & Khan, A. (2023). Angiotensin-converting enzyme and hypertension: a systemic analysis of various ACE inhibitors, their side effects, and bioactive peptides as a putative therapy for hypertension. Journal of the Renin-angiotensin-aldosterone System: JRAAS, 2023.

Brouwers, S., Sudano, I., Kokubo, Y., & Sulaica, E. M. (2021). Arterial hypertension. The Lancet, 398(10296), 249-261.

Carey, R. M., Moran, A. E., & Whelton, P. K. (2022). Treatment of hypertension: a review. Jama, 328(18), 1849-1861.

Cutrell, S., Alhomoud, I. S., Mehta, A., Talasaz, A. H., Van Tassell, B., & Dixon, D. L. (2023). ACE-Inhibitors in Hypertension: A historical perspective and current insights. Current Hypertension Reports, 25(9), 243-250.

El Mokadem, M., Abd El Hady, Y., & Aziz, A. (2020). A prospective single-blind randomized trial of ramipril, eplerenone and their combination in type 2 diabetic nephropathy. Cardiorenal medicine, 10(6), 392-401.

Fujimura, A., & Ushijima, K. (2023). Understanding the role of chronopharmacology for drug optimization: what do we know?. Expert Review of Clinical Pharmacology, 16(7), 655-668.

Komilovich, E. B. (2024). HYPERTENSION TREATMENT. ОБРАЗОВАНИЕ НАУКА И ИННОВАЦИОННЫЕ ИДЕИ В МИРЕ, 38(7), 227-234.

Marjot, T., Ray, D. W., & Tomlinson, J. W. (2022). Is it time for chronopharmacology in NASH?. Journal of hepatology, 76(5), 1215-1224.

Mawarni, O. I., Krisnadewi, A. A. I., Putri, E. M., Dhafin, A. A., & Prasetyawan, F. (2024). Type II Diabetes Mellitus And Anti-Diabetic Therapy Patterns In Hospital X, Central Java. Journal Health of Indonesian, 2(02), 77-86.

Motrapu, M., Świderska, M. K., Mesas, I., Marschner, J. A., Lei, Y., Valenzuela, L. M., ... & Anguiano, L. (2020). Drug testing for residual progression of diabetic kidney disease in mice beyond therapy with metformin, ramipril, and empagliflozin. Journal of the American Society of Nephrology, 31(8), 1729-1745.

Nababan, O. A., Prasetyawan, F., Saristiana, Y., Muslihk, F. A., Mildawati, R., & Oktadiana, I. (2024). Gambaran Penggunaan Obat Tunggal Antihipertensi Pada Pasien Hipertensi Di Rawat Jalan Puskesmas. Jurnal Intelek Insan Cendikia, 1(1), 22-29.

Nisa, C. F., (2022). Studi Kronofarmakologi Penggunaan Ramipril pada Pasien Hipertensi di RSUD Singaparna Medika Citrautama Kabupaten Tasikmalaya (Doctoral dissertation, UNIVERSITAS BTH TASIKMALAYA).

Nisa, F. C., Alifiar, I., Hidayati, N. L. D., & Tenderly, V. F. (2022). Studi Kronofarmakologi Penggunaan Ramipril Pada Pasien Hipertensi di RSUD Singaparna Medika Citrautama Kabupaten Tasikmalaya. Borneo Journal of Pharmascientech, 6(2), 99-103.

Park, H. S., Lee, D. H., Han, J. H., Jung, S. H., Lee, M., Jang, K. W., & Myung, C. S. (2020). The effects of combined treatment of losartan and ramipril on hypertension and related complications. Journal of Pharmaceutical Investigation, 50, 573-581.

Prasetyawan, F., Saristiana, Y., Muslikh, F. A., Arifin, C., Rofiq, A., Putri, E. M., & Dhafin, A. A. (2024). Patterns of Antihypertensive Medication Utilization Among Hypertensive Patients: A Review of Single-Therapy Practices in Outpatient Primary Healthcare Centers. Journal Health of Indonesian, 2(02), 52-57.

Prasetyawan, F., Saristiana, Y., Muslikh, F. A., Mildawati, R., Ariawan, W., Arifin, C., ... & Zahra, I. (2024). Calculation of Average Cost Effectiveness Ratio in Hypertensive Patients Using Angiotensin-Converting Enzyme Inhibitor Combined with Calcium Channel Blocker in Inpatient Pharmacy Facility. International Journal of Asian Business and Development, 1(1).

Rohmiati, S. (2022). Studi Kronofarmakologi Penggunaan Ramipril pada Pasien Hipertensi di RSUD Dr. Soekardjo Tasikmalaya (Doctoral dissertation, UNIVERSITAS BTH TASIKMALAYA).

Saristiana, Y., Prasetyawan, F., Muslikh, F. A., Dhafin, A. A., Mildawati, R., Putri, E. M., & Raharjo, S. M. (2023). Utilization of Antiviral Medications in COVID-19 Patients with Chronic Kidney Disease in Hospital. International Journal of Contemporary Sciences (IJCS), 1(1), 27-32.

Setiya, A. (2009). Pengaruh sirkadian pada farmakokinetik sulfametoksazol oral dengan data darah kelinci. Majalah Farmasi Airlangga, 7(1).

Turner, J. M., & Kodali, R. (2020). Should angiotensin-converting enzyme inhibitors ever be used for the management of hypertension?. C

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Published

2024-06-13

How to Cite

Fendy Prasetyawan, Faisal Akhmal Muslikh, Yuneka Saristiana, Ratna Mildawati, Chandra Arifin, Abd Rofiq, & Dewi Retno Puspitosari. (2024). Chronopharmacological Study Of Angiotensin-Converting Enzyme Inhibitor Ramipril In Hypertensive Patients In A Hospital: Analysis Of Efficacy And Tolerability Based On Administration Time Variations. Jurnal Ilmiah Multidisiplin Indonesia (JIM-ID), 3(02), 103–111. https://doi.org/10.58471/esaprom.v3i02.4752