What is hypertension? Hypertension is the medical term for high blood pressure. When blood flows through the blood vessels it pushes against their walls, almost like water pushing against the sides of a hose. Blood pressure is like that “push”. When blood pressure is high (like the water pressure in a hose when the nozzle is partially shut), damage can occur to the heart and blood vessels.

Although you may not feel any symptoms for years, hypertension can lead to stroke, heart attack, kidney disease and other serious conditions.

What causes hypertension?

In most cases, the exact cause of hypertension is not known. But we do know that several factors increase the risk of developing the disease.

Family history: Hypertension, like some other diseases, can run in families. If your parents have high blood pressure, your chances of developing it are greater.

Age: The risk of developing hypertension increases with age.

Race: In North America, there is a higher incidence of hypertension among blacks than among whites.

Diabetes: Diabetics are at higher risk of developing hypertension than nondiabetics.

Weight: The risk of high blood pressure is higher in people who are overweight.

Drinking: Heavy alcohol consumption increases risk of hypertension, as well as stroke and kidney disease.

Sedentary lifestyle: A physically inactive lifestyle can contribute to hypertension.

Smoking: While not a direct cause of hypertension, smoking a cigarette will temporarily increase blood pressure. Smoking also increases the risk of heart disease in people with high blood pressure.

About Altace:

Your doctor has prescribed Altace, a medication that helps to control blood pressure. Altace opens blood vessels to reduce blood pressure, like the way opening a hose reduces water pressure. It is not, however, a cure.

But it takes more than just medication to reduce blood pressure. Discuss the risk factors, and how they apply to your lifestyle, with your doctor. You may have to modify some of your daily habits to keep your blood pressure down.

Exercise regularly. It will help to keep your weight down, make you feel more energetic and is a good way to deal with stress. If you are not exercising regularly, be sure to discuss a fitness plan with your doctor.

Remember, hypertension is a long-term disease without symptoms. Just because you feel fine does not mean you can stop taking your medication. If you stop, serious complications of the disease may occur. Therefore, you should continue to take it regularly, as prescribed by your doctor.

For patients following a recent heart attack

Your doctor has prescribed Altace to reduce the effort required by your heart to pump blood, to compensate for reduced pumping power that may have resulted from your heart attack.

Altace has been shown to improve survival and reduce hospitalizations in patients recovering from recent heart attacks.

If you have developed heart failure after a heart attack, you may have to limit your physical activities. Before you begin exercising, be sure to consult with your doctor.

When initiating therapy in patients with heart failure after a heart attack, Altace is usually given twice a day, in the morning and in the evening. Take your medication as instructed by your doctor.

Management of Patients at Increased Risk of Cardiovascular Events

Your doctor has prescribed Altace because:

• You have coronary heart disease (such as chest pains or angina, or have had a heart attack in the past).
  
• You had a stroke.
  
• You have peripheral vascular disease (poor blood circulation).
  
• You have diabetes and at least 1 of the following physical conditions: high blood pressure, elevated total cholesterol levels, low high-density lipoprotein (HDL) levels, cigarette smoking or documented microalbuminuria.
  

Altace may lower the risk of heart attack, stroke, or death from a heart disease in some patients who have a heart problem or poor blood circulation. Take your medication as instructed by your doctor.

General Information

When to take your medication: It is important to take it at the same time every day as prescribed by your doctor.

Missed a dose? If you forget to take your Altace capsule, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double dose.

Managing your lifestyle: The “lifestyle” part of your treatment is as important as your medication. By working as a team with your doctor, you can help reduce the risk of complications to maintain the style of life you are accustomed to.

Alcohol: Avoid alcoholic beverages until you have discussed their use with your doctor. Alcohol consumption may alter your blood pressure and/or increase the possibility of dizziness or fainting.

Diet: Generally, avoid fatty foods and food that is high in salt or cholesterol.

Smoking: Avoid it completely.

Side effects

Along with its intended action, any medication, including Altace, may cause side effects. These include

• headache
• dizziness
• fatigue
• nausea
• coughing

These side effects will disappear once your system becomes used to the medication. If they persist, discuss this with your doctor. Your medication might have to be reduced or changed.

Dizziness or lightheadedness may occur after the first dose of this medicine. Make sure you know how you react to this medicine before you drive, operate machinery, or do anything requiring you to be alert.

If you are suffering from excessive sweating, vomiting or diarrhea, this may cause you to lose too much water and lead to problems with low blood pressure. See your doctor.

A rare, but potentially more serious, side effect is called angioedema--characterized by swollen mouth, lips, tongue, eyes, throat or difficulty in swallowing or breathing. If you notice swelling or feel pain in these areas, inform your doctor immediately. You should also inform your doctor if you have an unexplained fever, rash or itching.

Before taking Altace

Keep your doctor informed. It is important that you inform your doctor of the following:

• Are you currently taking any other medications, whether on prescription or otherwise? This is especially important if you are taking diuretics (water pills) or any other medication to reduce blood pressure which may add to the blood pressure lowering effect of Altace. You should not be taking salt substitutes, potassium supplements or potassium containing medicine without the advice of your doctor.
  
• Do you suffer from any other condition? The presence of other medical problems may affect the use of Altace. Make sure you tell your doctor if you have any other medical problems, especially if you have diabetes, liver disease, kidney disease, heart or blood vessel disease.
  
• If you are being treated for other conditions by other doctors, keep them all informed of which medications you are taking. Some drugs may have a negative effect on Altace or Altace may have a negative effect on other drugs. If you have to undergo any dental or other surgery, inform the dentist or physician in charge that you are taking this medicine.
  
• Are you pregnant, breast-feeding or thinking of becoming pregnant? Taking Altace during pregnancy can cause injury and even death to the fetus. It is not known if Altace passes into breast milk. You should not breast-feed while taking Altace.
  
• Are you possibly allergic to Altace (ramipril), including any of its nonmedicinal ingredients (pregelatinized starch NF, gelatin, titanium dioxide)?
  

After you have started taking Altace, it is important that you tell your doctor at once about any unexplained symptom you might experience. Examples of this are:

• unexplained fever
• rash
• itching
• any sign of infection
• viral-like symptoms
• flu-like symptoms
• coughing
• sore throat
• abdominal pain
• loss of appetite
• sad mood
• jaundice

Storing Altace:

Store in original container at room temperature, below 25°C and not beyond the date indicated on the container. Keep this medication out of the reach of children.

Additional Notes

Use this drug as directed by your doctor. All drugs can have both helpful and harmful effects. Both depend on the person and his or her condition. This leaflet alerts you to some of the times you should call your doctor. Other situations which cannot be predicted can arise. Nothing in this leaflet should stop you from calling your doctor or pharmacist with any questions or concerns you have about Altace.