[The HOPE Study. What does it contribute to general practice?].
The HOPE study investigated the hypothesis that inhibition of the RAS with the ACE inhibitor, ramipril, prevents cardiovascular events in patients with a high cardiovascular risk. The primary endpoint of the double-blind, placebo-controlled study was the combination of myocardial infarction, stroke and cardiovascular death. The result was a significant reduction in the number of myocardial infarctions (9.9 vs. 12.2%), cardiovascular deaths (6.1 vs. 8.1%), strokes (3.4 vs. 4.9%) and revascularizations (16.0 vs. 18.6%) under the ACE inhibitor. The cough rate was raised (by 5%). The cardio- and nephroprotective benefits of ramipril were largely independent of the reduction in blood pressure achieved by the ACE inhibitor. The effects of rampipril in terms of micro- and macrovascular complications benefitted in particular type 2 diabetics with additional cardiovascular risk factors, so that this group should not be denied ramipril. The level of albumin excretion in the urine is directly coupled with the rate of cardiovascular events.
Mann
J
J
Klinikum Schwabing, München. tbno2ab@mail.lrz-muenchen.de
Sleight
P
P
D000368:Aged; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use*; D002318:Cardiovascular Diseases / Q000188:drug therapy* / Q000209:etiology / Q000401:mortality; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D017257:Ramipril / Q000627:therapeutic use*; D012307:Risk Factors; D015996:Survival Rate
D000806:Angiotensin-Converting Enzyme Inhibitors; D017257:Ramipril