[Ten years after publishing results from The Heart Outcomes Prevention Evaluation Study--HOPE: implications on treatment with angiotensin converting enzyme inhibitors in clinical practice]

Abstract

Ten years ago results from The Heart Outcomes Prevention Evaluation Study were published. Those results had a great impact on position of ACE inhibitors in clinical practice. In the study, comparison of ramipril in daily dosage up to 10 mg and placebo in 9541 patients with high cardiovascular risk during 4.5 years of follow-up resulted in relative risk reduction for all primary end-points: cardiovascular mortality, myocardial infarction and stroke for 22% in patients treated with ramipril. Systolic blood pressure was reduced minimally for 3 mmHg. The effect was independent of age, gender, concomitant diseases or therapy. Extended follow-up of the patients for further 2.6 years showed prolonged beneficial effect of ramipril. Ramipril reduced relative risk for newly developed diabetes for 34%. Results of the study greatly influenced the guidelines for treatment of patients with cardiovascular diseases. This study proved benefits of ACE inhibitors in primary prevention in patients with high cardiovascular risk.