Interventional - Drug
The objective of HOPE was to evaluate 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. HOPE led to regulatory approvals for a new indication for the study drug in 40 countries, with 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. The extension showed maintained benefit for ramipril and neutral effect for vitamin E.
HOPE included 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 more than 60 publications – one of which, in the The New England Journal of Medicine, was the most highest cited publication in clinical medicine in year 2001.
The primary study outcome was the composite of CV death, myocardial infarction and stroke. Secondary outcomes were all-cause death, revascularizations, hospitalization for heart failure, hospitalization for unstable angina and complications related to diabetes. All primary and secondary outcomes were adjudicated (except revascularizations.)HOPE Results - Download PDF
Interventional - Drug
Randomized double-blind controlled trial with a two-by-two factorial design
Executive Director; Senior Scientist
Salim Yusuf is an internationally renowned cardiologist and epidemiologist, whose work over 40 years has substantially influenced prevention and treatment of cardiovascular disease. Born in India, medically qualified at St. John’s Medical College, Bangalore in 1976, he received a Rhodes Scholarship and obtained a DPhil from Oxford, during which he (along with Richard Peto, Rory Collins and Peter Sleight) initiated the concepts of large, simple trials, and meta-analysis. He proposed the concept of combination drug treatment for prevention of CVD to achieve large reductions in CVD with a single pill (now called the polypill concept), but more importantly has been evaluating the concept through large randomized trials.
He leads several global studies involving more than 60 countries in every inhabited continent of the world aimed at enhancing knowledge about the biological, behavioural and societal causes, consequences, and approaches to the control of heart diseases, and strokes through large multi-country programs such as INTERHEART, INTERSTROKE, and PURE.
He holds a Heart and Stroke Foundation of Ontario Research Chair and has received (among others) the Lifetime Research Achievement award of the Canadian Cardiovascular Society; the Paul Wood Silver Medal of the British Cardiac Society; the European Society of Cardiology gold medal, the clinical Research Prize of the American Heart Association and the International Award and the Braunwald Lecture of the American College of Cardiology. He has been inducted into the Royal Society of Canada and the Canadian Medical Hall of Fame; been appointed as an Officer of the Order of Canada, and received the Canada Gairdner Wightman Award in 2014. He has received four honorary doctorates, and is among the top 20 most cited health researchers in history.
Salim Yusuf has published more than 1,000 articles in refereed journals, rising to the second most cited researcher in the world for 2011. He has mentored more than 120 scientists, several of whom are in leadership positions across the globe. He has been President of the World Heart Federation (2015-2016), where he initiated several programs (the Emerging Leaders program, road maps for CVD control and a course for training primary care practitioners in CVD prevention) aimed at halving the CVD burden globally within a generation. The World Heart Federation has recognized his contributions by naming the program the Salim Yusuf Emerging Leaders Programme.
He is a Distinguished University Professor of Medicine, and Executive Director of the Population Health Research Institute, McMaster University and Chief Scientist, Hamilton Health Sciences.
Jackie Bosch started working with Salim Yusuf in 1993, before PHRI was formally created, as she was completing her Masters in Clinical Epidemiology, with the intent to learn how to do clinical trials so she could run trials in post-stroke rehabilitation. Most recently, she has been a co-investigator on large trials in primary and secondary prevention of cardiovascular disease and diabetes, as well as understanding the causes of functional decline as well as developing simple, internationally applicable interventions to improve post-stroke disability.
She is Assistant Dean of the Occupational Therapy program, School of Rehabilitation Sciences, McMaster University, and has received awards such as the (McMaster) President’s Award for Outstanding Service, and the PHRI Award for Outstanding Contributions to Global Collaborations. She has more than 65 peer-reviewed publications.
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