Authors: Mcqueen, M. J.; Lonn, E.; Gerstein, H. C.; Bosch, J.; Yusuf, S.

Source: Scandinavian Journal of Clinical and Laboratory Investigation, Volume 65, Supplement 240, Supplement 240/01Jun2005 , pp. 143-156(14)

Publisher: Informa Healthcare

Abstract:

The HOPE study was a 19 country, prospective randomized trial in which the ACE-inhibitor Ramipril but not Vitamin E significantly reduced the risk of future cardiovascular events in a high-risk population of men and women, including many with diabetes. The benefits were present in all sub-groups, independent of the presence or absence of diabetes, hypertension, evidence of cardiovascular disease, microalbuminuria, blood pressure lowering, the use of aspirin, lipid-lowering or antihypertensive medication. It provided clear evidence that Ramipril should safely and cost-effectively be used in individuals not known to have low ventricular ejection fraction or heart failure but at high-risk of cardiovascular events. It was also beneficial in patients with renal insufficiency, reducing progression of proteinuria and development of new microalbuminuria. It provided micro- and macrovascular benefits in people with diabetes, reduced the development of new cases of diabetes and showed a positive and graded association between the waist-to-hip ratio and the risk of developing diabetes. Sub-studies completed and on-going into the predictive role of natriuretic peptides, infectious and inflammatory markers, provide insight into possible mechanisms of action of Ramipril.

Document Type: Research article

DOI: http://dx.doi.org/10.1080/00365510500236366

Affiliations: 1: Population Health Research Institute, Hamilton General Hospital, Hamilton Health Sciences, Hamilton, Ontario, Canada

Publication date: 2005-06-01

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