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Therapeutics
Ramipril reduced mortality and cardiovascular morbidity in high risk adults

https://doi.org/10.1136/ebm.5.2.47

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    (2000) N Engl J Med 342, 145. The Heart Outcomes Prevention Evaluation Study Investigators.. Effects of an angiotensin-converting-enzyme inhibitor, ramipril, on death from cardiovascular causes, myocardial infarction, and stroke in high-risk patients.. Jan 20;. :. –53.
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 QUESTION: In adults who are at high risk for cardiovascular (CV) events, does ramipril, an angiotensin converting enzyme (ACE) inhibitor, reduce CV events? (Vitamin E results will be reported separately.)

    Design

    Randomised {allocation concealed*}†, blinded (patients, clinicians, and outcome assessors),* controlled 2×2 factorial design trial with planned interim analyses (Heart Outcomes Prevention Evaluation [HOPE] study).

    Setting

    161 centres in North America, 76 in 14 western European countries, and 30 in Argentina and Brazil.

    Participants

    9541 adults (mean age 66 y, 73% men) who were aged ≥55 years and had a history of coronary artery disease, stroke, peripheral vascular disease, or diabetes and ≥1 other CV risk factor. Exclusion criteria were heart failure, ejection fraction <0.4, use of an ACE inhibitor, uncontrolled hypertension, …

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    Footnotes

    • Sources of funding: Medical Research Council of Canada; Hoechst-Marion Roussel; AstraZeneca; King Pharmaceuticals; Natural Source Vitamin E Association and Negma; Heart and Stroke Foundation of Ontario.

    • For correspondence: Dr S Yusuf, Canadian Cardiovascular Collaboration Project Office, Hamilton General Hospital, 237 Barton Street East, Hamilton, Ontario L8L 2X2, Canada. Fax +1 905 521 1166.

    • ↵* See glossary.

    • ↵† The HOPE Study Investigators. Can J Cardiol 1996;12:127–37.