Ramipril vs Candesartan: Scoping Review with ☸️SAIMSARA.

Name: SAIMSARA Evidence Object vascular::RAMIPRIL_VS_CANDESARTAN_SS
Creator: SAIMSARA
License: https://saimsara.com/license/

SAIMSARA

doi:10.62487/saimsarae1a78e09

SAIMSARA Journal

Machine-Readable Science • ISSN 3054-3991

Ramipril vs Candesartan: Scoping Review with ☸️SAIMSARA.

Cardiac & Vascular Health

Issue 1, Volume 1, 2026

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DOI: 10.62487/saimsarae1a78e09

Editorial note

• Last update: 2026-06-02 22:03:19

What is this paper about

This review shows that ramipril and candesartan are not simply interchangeable RAAS drugs: blood-pressure control is broadly comparable, but the evidence separates them by exercise BP response, tolerability, diastolic function, anti-fibrotic signals, and perioperative fibrinolytic effects. The full read maps 37 references across 33 original studies and 399,243 observations, clarifying where candesartan, ramipril, or single-pill combinations may offer the more rational clinical choice.

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Abstract: The aim of this scoping review is to systematically synthesize and evaluate the comparative efficacy, safety, tolerability, and physiological impacts of ramipril versus candesartan across experimental animal models, laboratory biological systems, and clinical cohorts. The review uses 37 references and builds its evidence map from 33 original studies with 399243 total participants/sample observations (topic-deduplicated ΣN). This scoping review suggests that ramipril and candesartan offer broadly comparable blood-pressure control but diverge meaningfully in tolerability and selected target-organ effects, with candesartan associated with superior exercise blood-pressure reduction in a small crossover study reported across related records, diastolic function improvement, and sustained anti-fibrotic activity, and ramipril showing distinct perioperative bradykinin and fibrinolytic effects during cardiopulmonary bypass. Single-pill combinations of either agent with amlodipine were associated with improved persistence and lower cardiovascular event or mortality risk (HR 0.77 and 0.80) compared with multi-pill regimens. Tolerability signals, including cough and rare bronchial cast formation with ramipril, support individualized switching when class-specific adverse effects emerge. Given the heterogeneous and largely non-pooled evidence base, future head-to-head trials should clarify which patient phenotypes—defined by sex, comorbidity, or exercise exposure—derive the greatest differential benefit from each agent.
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Keywords: Ramipril; Candesartan; Angiotensin-converting enzyme inhibitors; Angiotensin receptor blockers; Hypertension; Antihypertensive therapy; Cardioprotection; Endothelial function; Blood pressure regulation; Adverse drug events

Review Stats

Final search date and database lock: 2026-05-24 10:51:42 CEST
Plan: Pro (expanded craft tokens; source: Semantic Scholar)
Source: Semantic Scholar
Total Abstracts/Papers: 269
Downloaded Abstracts/Papers: 269
Included original and non-original Abstracts/Papers (all): 41
Included original Abstracts/Papers (Vote counting by direction of effect): 33
Reference Index (links used in paper): 37
Total participants/sample observations (topic deduplicated ΣN): 399243

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Reference Index (37)

[1] Study of possible sex features of ramipril and candesartan treatment under experimental arterial hypertension in rats. — https://doi.org/10.5817/csf2022-3-116
[2] Morphological changes in tissues of organs in rats with arterial hypertension (SHR) with treatment of hypotensive medicines (with ramipril and candesartan) in combination with corvitin — https://doi.org/10.15587/2519-4852.2020.197300
[3] Protective Role of Ramipril and Candesartan against Myocardial Ischemic Reperfusion Injury: A Biochemical and Transmission Electron Microscopical Study — https://doi.org/10.1155/2016/4608979
[4] Pharmacoeconomic analysis of the use of ramipril and candesartan in patients with arterial hypertension — https://doi.org/10.15587/2519-4852.2018.135771
[5] Evaluasi Penggunaan Ramipril dan Candesartan pada Pasien Rawat Inap COVID-19 dengan Komorbid Hipertensi di RSUD Dr. Moewardi — https://doi.org/10.22435/jki.v13i1.6064
[6] Effect of Candesartan and Ramipril on Liver Fibrosis in Patients with Chronic Hepatitis C Viral Infection: A Randomized Controlled Prospective Study — https://doi.org/10.1016/j.curtheres.2021.100654
[7] PERBANDINGAN EFEKTIVITAS KOMBINASI CARVEDILOL – RAMIPRIL DAN BISOPROLOL – CANDESARTAN PADA PASIEN GAGAL JANTUNG KONGESTIF DI RSUD CIAWI — https://doi.org/10.47219/ath.v6i1.119
[8] Der AT1-Rezeptorantagonist Candesartan senkt bei Hypertonikern den Belastungsblutdruck stärker als der ACE-Hemmer Ramipril — https://doi.org/10.5414/nhp35094

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