Heart Outcomes Prevention Evaluation Study Investigators. Effects of an angiotensin-converting-enzyme inhibitor, ramipril, on cardiovascular events in high-risk patients. N Engl J Med 2000;342:145-53.

Abstract

than 65, and just over one-quarter were women. Most patients (80%) had a history of coronary artery disease, about half were hypertensive (46.8%), and many (38.5%) had diabetes mellitus. A chart audit found that more than half of the patients had had their ventricular function assessed before the study. Of this group, 8.1% had a low ejection fraction without a clinical history of congestive heart failure. The study was designed to continue for 5 years, but it was stopped early because of the beneficial effects of ramipril on the primary outcome. The primary end point occurred in 14.0% of the patients in the treatment group, as compared with 17.8% in the placebo group.