Evidence map›Paper›PMID 10675071›Full record

Trial reportLancet (London, England)2000

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.

Erratum issuedAbstract readClinical TrialMulticenter StudyRandomized Controlled Trial
PubMed
In one paragraph

Trial report in Lancet (London, England), 2000. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 769 papers, 28 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
769citing papers in PubMed, 28 pooled it
110.4field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

769 citing papers in PubMed, 28 syntheses or guidelines pooled it, 2,103 citations in OpenAlex.

  1. Guideline
  2. Pharmacotherapy for mild hypertension.The Cochrane database of systematic reviews · 2026
    Pooled it
  3. Guideline
  4. Pharmacotherapy for mild hypertension.The Cochrane database of systematic reviews · 2025
    Pooled it
  5. Guideline
  6. Pooled it
  7. Pooled it
  8. Antioxidants for adults with chronic kidney disease.The Cochrane database of systematic reviews · 2023
    Pooled it
  9. Guideline
  10. Pooled it
  11. Pooled it
  12. Blood pressure control for diabetic retinopathy.The Cochrane database of systematic reviews · 2023
    Pooled it
  13. Pooled it
  14. American Association of Clinical Endocrinology Clinical Practice Guideline: Developing a Diabetes Mellitus Comprehensive Care Plan-2022 Update.Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists · 2022
    Guideline
  15. Guideline
  16. Pooled it
  17. Guideline
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  19. Guideline
  20. Pooled it

709 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

0 authors.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundDiabetes mellitus is a strong risk factor for cardiovascular and renal disease. We investigated whether the angiotensin-converting-enzyme (ACE) inhibitor ramipril can lower these risks in patients with diabetes.

methods3577 people with diabetes included in the Heart Outcomes Prevention Evaluation study, aged 55 years or older, who had a previous cardiovascular event or at least one other cardiovascular risk factor, no clinical proteinuria, heart failure, or low ejection fraction, and who were not taking ACE inhibitors, were randomly assigned ramipril (10 mg/day) or placebo, and vitamin E or placebo, according to a two-by-two factorial design. The combined primary outcome was myocardial infarction, stroke, or cardiovascular death. Overt nephropathy was a main outcome in a substudy.

findingsThe study was stopped 6 months early (after 4.5 years) by the independent data safety and monitoring board because of a consistent benefit of ramipril compared with placebo. Ramipril lowered the risk of the combined primary outcome by 25% (95% CI 12-36, p=0.0004), myocardial infarction by 22% (6-36), stroke by 33% (10-50), cardiovascular death by 37% (21-51), total mortality by 24% (8-37), revascularisation by 17% (2-30), and overt nephropathy by 24% (3-40, p=0.027). After adjustment for the changes in systolic (2.4 mm Hg) and diastolic (1.0 mm Hg) blood pressures, ramipril still lowered the risk of the combined primary outcome by 25% (12-36, p=0.0004).

interpretationRamipril was beneficial for cardiovascular events and overt nephropathy in people with diabetes. The cardiovascular benefit was greater than that attributable to the decrease in blood pressure. This treatment represents a vasculoprotective and renoprotective effect for people with diabetes.

Indexed as

AgedAngiotensin-Converting Enzyme InhibitorsCardiovascular DiseasesDiabetes ComplicationsDiabetic AngiopathiesDiabetic NephropathiesFemaleHumansHypertensionMaleRamiprilRisk FactorsAngiotensin-Converting Enzyme InhibitorsRamipril

Identifiers

PMID10675071
OpenAlexW2529012027

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.