The HOPE study. Ramipril lowered cardiovascular risk, but vitamin E did not

Cleve Clin J Med. 2000 Apr;67(4):287-93. doi: 10.3949/ccjm.67.4.287.


The Heart Outcomes Prevention Evaluation (HOPE) study found that the ACE inhibitor ramipril can lower the risk of atherosclerotic disease events and death in patients without heart failure but with known atherosclerosis or with diabetes plus at least one cardiovascular risk factor. This benefit was independent of ramipril's effect on blood pressure. Additional benefits were a reduced risk of diabetic nephropathy in diabetic patients, and a lower likelihood of newly diagnosed diabetes. On the other hand, vitamin E in the doses and duration studied (400 IU/day for 4.5 years) did not lower risk significantly.

Publication types

  • Clinical Trial
  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Albuminuria / complications
  • Angiotensin-Converting Enzyme Inhibitors / therapeutic use*
  • Cardiovascular Diseases / complications
  • Cardiovascular Diseases / prevention & control*
  • Diabetes Complications
  • Double-Blind Method
  • Female
  • Humans
  • Hypertension / complications
  • Male
  • Middle Aged
  • Ramipril / therapeutic use*
  • Risk Factors
  • Treatment Outcome
  • Vitamin E / therapeutic use*


  • Angiotensin-Converting Enzyme Inhibitors
  • Vitamin E
  • Ramipril