Trial reportCMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne2003
The striking effect of the Heart Outcomes Prevention Evaluation (HOPE) on ramipril prescribing in Ontario.
Trial report in CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne, 2003. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
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.
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.
Who cites it
15 citing papers in PubMed, 53 citations in OpenAlex.
- Impact of the ENHANCE trial on the use of ezetimibe in the United States and Canada.American heart journal · 2014 · on this mapTrial
- Impact of drug policy on regional trends in ezetimibe use.Circulation. Cardiovascular quality and outcomes · 2014Observational
- Statin use associates with a lower incidence of acute kidney injury after major elective surgery.Journal of the American Society of Nephrology : JASN · 2011Article
- The effect of antidepressant warnings on prescribing trends in Ontario, Canada.American journal of public health · 2007Article
- Impact of high dose statin trials on hospital prescribers.European journal of clinical pharmacology · 2007Article
- Prevalence, treatment, and control of hypertension in primary care: gaps, trends, and opportunities.Journal of clinical hypertension (Greenwich, Conn.) · 2007Article
- Article
- Do patients receive recommended treatment of osteoporosis following hip fracture in primary care?BMC family practice · 2006Article
- Evidence-based cardiovascular care in the community: a population-based cross-sectional study.BMC family practice · 2004Article
- The case for knowledge translation: shortening the journey from evidence to effect.BMJ (Clinical research ed.) · 2003Article
- More than just hype.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2003Article
- More than just hype.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2003Article
- Ramipril use in Canada: HOPE or HYPE?CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2003Article
- Thirty-day in-hospital revascularization and mortality rates after acute myocardial infarction in seven Canadian provinces.The Canadian journal of cardiologyArticle
- Perceived outcomes of web-based modules designed to enhance athletic trainers' knowledge of evidence-based practice.Journal of athletic trainingArticle
Corrections and comments
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Authors and funding
6 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe Heart Outcomes Prevention Evaluation (HOPE), a Canadian-led, multicentre, randomized controlled trial, demonstrated the effectiveness of the ACE inhibitor ramipril in the secondary prevention of cardiovascular disease in patients who were at high risk for cardiovascular events but did not have left ventricular dysfunction or heart failure. We studied whether HOPE affected the prescribing of ACE inhibitors generally, and ramipril specifically, in Ontario, where the trial was coordinated.
methodsWe used linked administrative databases to examine prescribing patterns for ACE inhibitors in the 1.29 million to 1.54 million elderly (aged 66 and over) residents of Ontario during the study period and specifically those with diabetes or congestive heart failure. For all new prescriptions for these drugs filled between Jan. 1, 1993, and Mar. 31, 2001, we conducted time-series analyses to measure any association with the release of the HOPE results.
resultsThe monthly number of new prescriptions for ramipril from the time it was introduced in 1995 until HOPE's early termination, in April 1999, peaked at 58 per 100,000 elderly Ontario residents. The rate increased to 92/100,000 in May, coincident with newspaper coverage of the trial's early termination, then fell back to 63/100,000 in August. After HOPE's results were formally released, starting Aug. 31, the rate increased significantly; it peaked at 304/100,000 in May 2000 (p < 0.01). The market share of ramipril among ACE inhibitors also increased significantly (p < 0.01), both overall and among patients with diabetes or congestive heart failure.
interpretationHOPE led to a striking and unprecedented increase, over 400%, in ramipril prescribing to elderly Ontario residents, including those not eligible for the trial. Many physicians are now prescribing ramipril for patients with diabetes or congestive heart failure.
Indexed as
Identifiers
12615747PMC149247W2160308837What OpenQuestion holds
Registered trials
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.