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To the Editor: Dr Yusuf and colleagues,¹ for the Heart Outcomes Prevention Evaluation (HOPE) study investigators, reported that patients with known vascular disease had lower risk of developing diabetes if they were given ramipril rather than placebo. The initial publication of the HOPE study² reported a 22% decrease in the composite end point of myocardial infarction, stroke, or death from cardiovascular causes among high-risk patients treated with ramipril compared with placebo. There were also statistically significant decreases in each component of the composite end point as well. Similarly, that previous article reported results of preplanned subgroup analysis that showed ramipril to be of particular benefit in patients with diabetes mellitus, microalbuminuria, hypertension, and cardiovascular disease. The authors observed that a new diagnosis of diabetes mellitus was made less frequently in the treatment group compared with the placebo group.²

Other reports from this same dataset have provided new information, eg, the . . . [Full Text of this Article]

RELATED LETTER

Ramipril and the Development of Diabetes
Salim Yusuf, Hertzel Gerstein, Byron Hoogwerf, Janice Pogue, Jackie Bosch, Bruce H. R. Wolffenbuttel, Bernard Zinman, and for the HOPE Study Investigators
JAMA. 2001;286(15):1882-1885.
ABSTRACT | FULL TEXT  

RELATED ARTICLE

Ramipril and the Development of Diabetes
Salim Yusuf, Hertzel Gerstein, Byron Hoogwerf, Janice Pogue, Jackie Bosch, Bruce H. R. Wolffenbuttel, Bernard Zinman, and for the HOPE Study Investigators
JAMA. 2001;286(15):1882-1885.
ABSTRACT | FULL TEXT