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An important article in this issue of the Journal describes the results of the Heart Outcomes Prevention Evaluation (HOPE) study, which are likely to have important implications for the treatment of cardiovascular disease.1 The findings indicate that ramipril, an angiotensin-converting–enzyme (ACE) inhibitor, substantially lowers the risk of death, heart attack, stroke, coronary revascularization, heart failure, and complications related to diabetes mellitus in a high-risk group of patients with preexisting vascular disease. The study was stopped early by the data and safety monitoring board because of the obvious benefit of ramipril. The results are remarkable both for the magnitude of the . . .
Gary S. Francis (2000) studied this question.