Ramipril: cardioprotective activity goes beyond BP reduction

The 1999 HOPE (Heart Outcomes Prevention Evaluation) study represented a new paradigm in clinical trials for hypertension in that few, if any, trials prior to this had investigated hypertension in high-risk patients, specifically those who had already experienced a myocardial infarction or stroke or had significant cardiovascular/cerebrovascular disease.* Dr Jeffrey Probstfield, professor of medicine and epidemiology at the University of Washington, Seattle, US, discussed the HOPE study in a presentation at the annual meeting of the American Stroke Association [San Antonio, US; February 2002]. In particular, though, he expanded on one small sub-group analysis that could shed important light on why the results of the overall study turned out the way they did.