Implications of the Heart Outcomes Prevention Evaluation (HOPE) for the treatment of patients at high cardiovascular risk; systolic versus diastolic pressure predictive value

The HOPE Study (NEJM Jan 14 2000) was a factorial randomised controlled trial testing the effect of Vit. E (400 i.u. od) and/or an ACE inhibitor (ramipril, 10mg od) on cardiovascular outcomes in over 9000 high risk subjects aged >55 years (mean 66 yrs) over 4.5 years. Highly significant reductions in myocardial infarction (MI, 20%), stroke (31%), Cardiovascular death (26%), revascularisation (16%), heart failure (22%) and diabetic complications …