Population Health Research Institute
Study List

HOPE and HOPE EXTENSION  (Completed)
Heart Outcomes Prevention Evaluation

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 To open a new browser and visit the external HOPE website, please click here

The HOPE trial evaluated the use of the ACE inhibitor ramipril and of vitamin E in high-risk patients with chronic stable vascular disease and/or diabetes and additional risk factor(s).  The trial showed clear benefit for ramipril and a neutral effect for vitamin E. Considered a landmark trial sin CV prevention, HOPE led to regulatory approvals for a new indication for the study drug in 40 countries and had a major impact on guidelines and patterns of practice worldwide. The HOPE Extension trial consisted of passive follow-up for ramipril arm of the trial and continued blinded study drug administration and follow-up for the vitamin E of the trial for additional 2.6 years and showed maintained benefit for ramipril and neutral effect for vitamin E. HOPE  included also a large number of substudies and additional analyses (carotid IMT, LV function, economic substudy, biomarkers, renal outcomes, heart failure, effects in people with diabetes, women, the elderly) and over 60 publications.

Study Design: Randomized double-blind RCT with a factorial design.

Intervention: Ramipril and Vitamin E vs. Placebo.

Length of Study: 5.5 years (HOPE Extension 2.6 years)

# of Patients: 9541

Patient Populations: High-risk chronic stable vascular disease (coronary heart disease, peripheral arterial disease, previous stroke and diabetes with additional risk factors).


HOPE Final Results

Main Publications (for a full listing of publications, please visit the 'Media and Publications' section)

Yusuf S, Sleight P, Pogue J, Bosch J, Davies R, Dagenais G; The 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. - highest cited publication in clinical medicine in year 2000

Yusuf S, Dagenais G, Poge J, Bosch J, Sleight P; The Heart Outcomes Prevention Evaluation Study Investigators. Vitamin E supplementation and cardiovascular events in high-risk patients. N Engl J Med 2000 Jan 20;342:154-60.

The HOPE Investigators. Effects of ramipril on cardiovascular and microvascular outcomes in people with diabetes mellitus: results of the HOPE study and MICRO-HOPE substudy. Heart Outcomes Prevention Evaluation Study Investigators. Lancet 2000;355:253-9.

Lonn E, Bosch J, Yusuf S, Sheridan P, Pogue J, Arnold JM, Ross C, Arnold A, Sleight P, Probstfield J, Dagenais GR; HOPE and HOPE-TOO Trial Investigators. Effects of long-term vitamin E supplementation on cardiovascular events and cancer: a randomized controlled trial. JAMA. 2005;293:1338-47.

 Bosch J, Lonn E, Pogue J, Arnold JM, Dagenais GR, Yusuf S; HOPE/HOPE-TOO Study Investigators. Long-term effects of ramipril on cardiovascular events and on diabetes: results of the HOPE study extension. Circulation 2005;112:1339-46.

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