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EASD: Ramipril Reduces Risk Of Heart And Kidney Complications In Diabetics BRUSSELS, BELGIUM -- October 4, 1999 -- Treatment with ramipril, an ACE inhibitor, can significantly reduce the risk of heart attack, stroke, cardiovascular death and kidney disease in high-risk people with diabetes, according to data reported recently at the annual meeting of the European Association for the Study of Diabetes (EASD). Results of the groundbreaking HOPE (Heart Outcomes Prevention Evaluation) Study indicate that ramipril reduced the risk of heart attack, stroke, and cardiovascular death by 24 per cent in people with diabetes, and reduced the risk of kidney disease by 23 per cent. Conducted at 267 centers in 19 countries, the HOPE Study was designed to compare the effects of ramipril on top of standard therapy, with placebo and vitamin E in patients at high risk for cardiovascular events. In Canada, 129 clinical investigators and 5,721 patients (60 per cent of participants) took part in the study. Because diabetes is a major risk factor for cardiovascular disease, more than one-third of the 9,500 patients in the total study population had diabetes. "These results show that ACE inhibition with ramipril safely prevents cardiovascular outcomes and deaths. This is good news for middle-aged and older people with diabetes who are at high-risk for heart disease," said Hertzel Gerstein, M.D., co-chairman of the diabetes component of HOPE and Director of the Division of Endocrinology and Metabolism in the faculty of Health Sciences at McMaster University, Hamilton, Ontario. The beneficial effects of ramipril on cardiovascular outcomes appear to be independent of its blood pressure-lowering effects and its protective effects on diabetes-related kidney disease, Dr. Gerstein reported. In fact, many patients with diabetes in this study had normal blood pressure. The HOPE Study included 3,578 patients with diabetes and at least one other cardiovascular risk factor, such as hypertension or high cholesterol. The patients’ average age was 65, and the average duration of their diabetes was 11 years. Patients were monitored for 4.5 years on average. Among people in the HOPE study population who did not report a history of diabetes, those treated with ramipril experienced a 30 per cent lower risk of being diagnosed with diabetes, a finding which warrants further investigation. Results of MICRO-HOPE, a substudy that will further explore the inter-relationship between diabetes, nephropathy and cardiovascular outcomes, will be released in the next few months. As with previous studies, the safety profile of ramipril in HOPE was comparable to placebo. The only adverse event that was associated with ramipril was a five per cent excess of cough which is seen with other ACE inhibitors. Ramipril is contraindicated in patients who are hypersensitive to the product or who have a history of angioedema related to previous treatment with an ACE inhibitor. Ramipril is an ACE inhibitor marketed by Hoechst Marion Roussel and is currently indicated for the treatment of essential hypertension, as well as post acute myocardial infarction. Ramipril is marketed in over 65 countries. In Canada, Ramipril is marketed by Hoechst Marion Roussel, under the name Altace®. Related Link: Hoechst Marion Roussel. E-mail this page to a friend or colleague! To print, use this version