ACE inhibitor (Ramipril 10mg/day) vs Placebo (High-risk of cardiovascular disease without LVSD or heart failure)

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Study population:

Patients at high-risk of cardiovascular disease without LVSD or heart failure.

High-risk of cardiovascular disease defined as: history of coronary heart disease, stroke, peripheral vascular disease or diabetes plus one other cardiovascular risk factor (hypertension, elevated total cholesterol, low HDL cholesterol, cigarette smoking or micro-albuminuria). 

Comments:

Mean age of enrolled patients was 66 years.   >50% of patients had a history of MI.

Ramipril reduced the risk of myocardial infarction, stroke, coronary revascularisation and heart failure.

There are no data to support ARBs for this indication.

 

Outcome Duration NNT Annualised NNT
Prevent one death (any cause) 60 months

54

270

References

Yusuf S. Sleight P. Pogue J. Bosch J. Davies R. Dagenais G. Effects of an angiotensin-converting-enzyme inhibitor, ramipril, on cardiovascular events in high-risk patients. The Heart Outcomes Prevention Evaluation (HOPE) Study Investigators. New England Journal of Medicine. 2000; 342 (3): 145-153