Dott. Carlo Sebastiano Tadeo
Ramipril Study Suggests Protection Against Progression of Atherosclerosis
NEW YORK, NY -- May 23, 2000 -- New findings reveal that ramipril, an angiotensin converting enzyme (ACE) inhibitor, "reduced the risk of serious cardiovascular events and suggest a vasculo-protective effect of ramipril, independent of blood pressure reduction," says Peter Sleight, MD.
Dr. Sleight, one of the study co-chairs of the HOPE trial (Heart Outcomes Prevention Evaluation), presented the findings at the American Society of Hypertension meeting. The study was a collaboration between the University of Oxford, in Oxford, UK, and McMaster University, in London, Ontario, Canada.
The HOPE trial was a study of 9,541 high-risk patients (older than 55 years) who were randomly given either ramipril (10 mg od) or vitamin E (400 mg od) over 18 months. The trial was stopped earlier than expected due to the significant benefit seen from ramipril.
In a sub-study of HOPE, called SECURE (Study to Evaluate Carotid Ultrasound changes with Ramipril and Vitamin E), carotid ultrasound progression of atherosclerosis was followed in the same high risk patients. They were randomly given 10 mg od of ramipril, 2.5mg od of ramipril, 400 mg od of vitamin E, or placebo.
Results of SECURE show that blood pressure was reduced by the same amount (4/2 mm Hg) by the two doses of ramipril. Progression of carotid atherosclerosis was significantly reduced by the higher ramipril dose. Vitamin E showed neither benefit nor harm.
"In both the SECURE and main HOPE study, there was a clear benefit from ramipril, even after adjustment for baseline blood pressure and change in blood pressure," Dr. Sleight said.
New sub-studies in diabetic patients also support a protective effect in the carotid wall independent of blood pressure reduction, he added.
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