Use of ramipril in preventing stroke: double blind randomised trial

doi:10.1136/bmj.324.7339.699

BMJ 2002;324:699 ( 23 March )

Papers

Use of ramipril in preventing stroke: double blind randomised trial

Jackie Bosch, assistant professor, ^a Salim Yusuf, professor of medicine, ^a Janice Pogue, senior statistician, ^a Peter Sleight, professor emeritus, ^b Eva Lonn, associate professor of medicine, ^a Badrudin Rangoonwala, medical consultant, ^c Richard Davies, associate professor, ^d Jan Ostergren, researcher, ^e Jeff Probstfield, professor of medicine, ^f on behalf of the HOPE Investigators.

^a Canadian Cardiovascular Collaboration, McMaster University, 237 Barton St E, Hamilton, ON, Canada L8L 2X2, ^b Cardiac Department, John Radcliffe Hospital, Oxford OX3 9DU, ^c Dahlien Weg 11, D65719 Hofheim-Taunus, Germany, ^d University of Ottawa Heart Institute, 40 Ruskin St, Ottawa, ON, Canada K1Y 4W7, ^e Karolinska Institute, Stockholm, Sweden SE-171 77, ^f University of Washington, 1124 Columbia Street, Seattle, WA 98104, USA

Correspondence to: J Bosch jackie{at}ccc.mcmaster.ca

Objective: To determine the effect of the angiotensinconverting enzyme inhibitor ramipril on the secondary preventionofstroke.
Design: Randomised controlled trial with 2×2 factorialdesign.
Setting: 267 hospitals in 19countries.
Participants: 9297 patients with vascular disease or diabetesplus an additional risk factor, followed for 4.5 years as partof the HOPEstudy.
Outcome measures: Stroke (confirmed by computed tomographyor magnetic resonance imaging when available), transient ischaemicattack, and cognitive function. Blood pressure was recorded atentry to the study, after 2 years, and at the end of thestudy.
Results: Reduction in blood pressure was modest (3.8mm Hg systolic and 2.8 mm Hg diastolic). The relative risk ofany stroke was reduced by 32% (156 v 226) in the ramipril groupcompared with the placebo group, and the relative risk of fatalstroke was reduced by 61% (17 v 44). Benefits were consistentacross baseline blood pressures, drugs used, and subgroups definedby the presence or absence of previous stroke, coronary arterydisease, peripheral arterial disease, diabetes, or hypertension.Significantly fewer patients on ramipril had cognitive or functionalimpairment.
Conclusion: Ramipril reduces the incidence of strokein patients at high risk, despite a modest reduction in bloodpressure.

What is already known on this topic
Treatment with aspirin and lowering blood pressure reduce the incidence of stroke

What this study adds
Ramipril, an angiotensin converting enzyme inhibitor, reduces strokes in patients at high risk whose blood pressure is not elevated, despite only a modest lowering of blood pressure

The benefits are observed even when patients receive aspirin and other blood pressure lowering treatments

© BMJ 2002

CiteULike

Complore

Connotea

Del.icio.us Add to Digg

Digg

Technorati What's this?

Timing of drug treatment is crucial: Martin Knapp
BMJ 2004 328: 167. [Extract] [Full Text]

Conundrum of the HOPE study: Time of taking ramipril may account for lack of relation between blood pressure and outcome: Roy Taylor
BMJ 2003 327: 681-682. [Extract] [Full Text]

Preventing stroke with ramipril $---$ authors' reply: Salim Yusuf, Jackie Bosch, and Peter Sleight
BMJ 2003 326: 52. [Extract] [Full Text]

Preventing stroke with ramipril: P Badrinath, Andrew P Wakeman, Jacqueline G Wakeman, John S Yudkin, Malvinder S Parmar, and Birte Twisselmann
BMJ 2002 325: 439. [Extract] [Full Text] [PDF]

Prolonged use of ramipril prevents stroke
BMJ 2002 324: 0. [Full Text] [PDF]

Stroke: physical and financial pathology
BMJ 2002 324: 0. [Full Text] [PDF]

Preventing stroke: Joachim Schrader and Stephan Lüders
BMJ 2002 324: 687-688. [Extract] [Full Text] [PDF]

This article has been cited by other articles:

Air, E. L., Kissela, B. M. (2007). Diabetes, the Metabolic Syndrome, and Ischemic Stroke: Epidemiology and possible mechanisms. Diabetes Care 30: 3131-3140 [Full text]
KNOPMAN, D S (2007). Cerebrovascular disease and dementia. Br. J. Radiol. 80: S121-S127 [Abstract] [Full text]
Khella, S., Bleicher, M. B. (2007). Stroke and Its Prevention in Chronic Kidney Disease. CJASN 2: 1343-1351 [Abstract] [Full text]
Yazdanpanah, M., Aulchenko, Y. S., Hofman, A., Janssen, J. A.M.J.L., Sayed-Tabatabaei, F. A., van Schaik, R. H.N., Klungel, O. H., Stricker, B. H.C.H., Pols, H. A.P., Witteman, J. C.M., Lamberts, S. W.J., Oostra, B. A., van Duijn, C. M. (2007). Effects of the Renin-Angiotensin System Genes and Salt Sensitivity Genes on Blood Pressure and Atherosclerosis in the Total Population and Patients With Type 2 Diabetes. Diabetes 56: 1905-1912 [Abstract] [Full text]
Willburger, R. E., Mysler, E., Derbot, J., Jung, T., Thurston, H., Kreiss, A., Litschig, S., Krammer, G., Tate, G. A. (2007). Lumiracoxib 400 mg once daily is comparable to indomethacin 50 mg three times daily for the treatment of acute flares of gout. Rheumatology (Oxford) 46: 1126-1132 [Abstract] [Full text]
Authors/Task Force Members:, , Mancia, G., De Backer, G., Dominiczak, A., Cifkova, R., Fagard, R., Germano, G., Grassi, G., Heagerty, A. M., Kjeldsen, S. E., Laurent, S., Narkiewicz, K., Ruilope, L., Rynkiewicz, A., Schmieder, R. E., Struijker Boudier, H. A.J., Zanchetti, A., ESC Committee for Practice Guidelines (CPG):, , Vahanian, A., Camm, J., De Caterina, R., Dean, V., Dickstein, K., Filippatos, G., Funck-Brentano, C., Hellemans, I., Kristensen, S. D., McGregor, K., Sechtem, U., Silber, S., Tendera, M., Widimsky, P., Zamorano, J. L., ESH Scientific Council:, , Kjeldsen, S. E., Erdine, S., Narkiewicz, K., Kiowski, W., Agabiti-Rosei, E., Ambrosioni, E., Cifkova, R., Dominiczak, A., Fagard, R., Heagerty, A. M., Laurent, S., Lindholm, L. H., Mancia, G., Manolis, A., Nilsson, P. M., Redon, J., Schmieder, R. E., Struijker-Boudier, H. A.J., Viigimaa, M., Document Reviewers:, , Filippatos, G., Adamopoulos, S., Agabiti-Rosei, E., Ambrosioni, E., Bertomeu, V., Clement, D., Erdine, S., Farsang, C., Gaita, D., Kiowski, W., Lip, G., Mallion, J.-M., Manolis, A. J., Nilsson, P. M., O'Brien, E., Ponikowski, P., Redon, J., Ruschitzka, F., Tamargo, J., van Zwieten, P., Viigimaa, M., Waeber, B., Williams, B., Zamorano, J. L. (2007). 2007 Guidelines for the Management of Arterial Hypertension: The Task Force for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). Eur Heart J 0: ehm236v1-75 [Full text]
Chitravas, N., Dewey, H. M., Nicol, M. B., Harding, D. L., Pearce, D. C., Thrift, A. G. (2007). Is prestroke use of angiotensin-converting enzyme inhibitors associated with better outcome?. Neurology 68: 1687-1693 [Abstract] [Full text]
Writing Committee Members, , Fuster, V., Ryden, L. E., Cannom, D. S., Crijns, H. J., Curtis, A. B., Ellenbogen, K. A., Halperin, J. L., Le Heuzey, J.-Y., Kay, G. N., Lowe, J. E., Olsson, S. B., Prystowsky, E. N., Tamargo, J. L., Wann, S., ACC/AHA Task Force Members, , Smith, S. C. Jr, Jacobs, A. K., Adams, C. D., Anderson, J. L., Antman, E. M., Halperin, J. L., Hunt, S. A., Nishimura, R., Ornato, J. P., Page, R. L., Riegel, B., ESC Committee for Practice Guidelines, , Priori, S. G., Blanc, J.-J., Budaj, A., Camm, A. J., Dean, V., Deckers, J. W., Despres, C., Dickstein, K., Lekakis, J., McGregor, K., Metra, M., Morais, J., Osterspey, A., Tamargo, J. L., Zamorano, J. L. (2006). ACC/AHA/ESC 2006 guidelines for the management of patients with atrial fibrillation: full text: A report of the American College of Cardiology/American Heart Association Task Force on practice guidelines and the European Society of Cardiology Committee for Practice Guidelines (Writing Committee to Revise the 2001 Guidelines for the Management of Patients With Atrial Fibrillation) Developed in collaboration with the European Heart Rhythm Association and the Heart Rhythm Society. Europace 8: 651-745 [Full text]
Fuster, V., Ryden, L. E., Cannom, D. S., Crijns, H. J., Curtis, A. B., Ellenbogen, K. A., Halperin, J. L., Le Heuzey, J.-Y., Kay, G. N., Lowe, J. E., Olsson, S. B., Prystowsky, E. N., Tamargo, J. L., Wann, S. (2006). ACC/AHA/ESC 2006 Guidelines for the Management of Patients With Atrial Fibrillation--Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the European Society of Cardiology Committee for Practice Guidelines (Writing Committee to Revise the 2001 Guidelines for the Management of Patients With Atrial Fibrillation) Developed in Collaboration With the European Heart Rhythm Association and the Heart Rhythm Society . J Am Coll Cardiol 48: 854-906 [Full text]
Fuster, V., Ryden, L. E., Cannom, D. S., Crijns, H. J., Curtis, A. B., Ellenbogen, K. A., Halperin, J. L., Le Heuzey, J.-Y., Kay, G. N., Lowe, J. E., Olsson, S. B., Prystowsky, E. N., Tamargo, J. L., Wann, S. (2006). ACC/AHA/ESC 2006 Guidelines for the Management of Patients With Atrial Fibrillation: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the European Society of Cardiology Committee for Practice Guidelines (Writing Committee to Revise the 2001 Guidelines for the Management of Patients With Atrial Fibrillation) Developed in Collaboration With the European Heart Rhythm Association and the Heart Rhythm Society . J Am Coll Cardiol 48: e149-e246 [Full text]
Fuster, V., Ryden, L. E., Cannom, D. S., Crijns, H. J., Curtis, A. B., Ellenbogen, K. A., Halperin, J. L., Le Heuzey, J.-Y., Kay, G. N., Lowe, J. E., Olsson, S. B., Prystowsky, E. N., Tamargo, J. L., Wann, S., ACC/AHA TASK FORCE MEMBERS, , Smith, S. C. Jr, Jacobs, A. K., Adams, C. D., Anderson, J. L., Antman, E. M., Halperin, J. L., Hunt, S. A., Nishimura, R., Ornato, J. P., Page, R. L., Riegel, B., ESC COMMITTEE FOR PRACTICE GUIDELINES, , Priori, S. G., Blanc, J.-J., Budaj, A., Camm, A. J., Dean, V., Deckers, J. W., Despres, C., Dickstein, K., Lekakis, J., McGregor, K., Metra, M., Morais, J., Osterspey, A., Tamargo, J. L., Zamorano, J. L. (2006). ACC/AHA/ESC 2006 Guidelines for the Management of Patients With Atrial Fibrillation: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the European Society of Cardiology Committee for Practice Guidelines (Writing Committee to Revise the 2001 Guidelines for the Management of Patients With Atrial Fibrillation): Developed in Collaboration With the European Heart Rhythm Association and the Heart Rhythm Society. Circulation 114: e257-e354 [Full text]
Fuster, V., Ryden, L. E., Cannom, D. S., Crijns, H. J., Curtis, A. B., Ellenbogen, K. A., Halperin, J. L., Le Heuzey, J.-Y., Kay, G. N., Lowe, J. E., Olsson, S. B., Prystowsky, E. N., Tamargo, J. L., Wann, S., ACC/AHA TASK FORCE MEMBERS, , Smith, S. C. Jr, Jacobs, A. K., Adams, C. D., Anderson, J. L., Antman, E. M., Halperin, J. L., Hunt, S. A., Nishimura, R., Ornato, J. P., Page, R. L., Riegel, B., ESC COMMITTEE FOR PRACTICE GUIDELINES, , Priori, S. G., Blanc, J.-J., Budaj, A., Camm, A. J., Dean, V., Deckers, J. W., Despres, C., Dickstein, K., Lekakis, J., McGregor, K., Metra, M., Morais, J., Osterspey, A., Tamargo, J. L., Zamorano, J. L. (2006). ACC/AHA/ESC 2006 Guidelines for the Management of Patients With Atrial Fibrillation--Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the European Society of Cardiology Committee for Practice Guidelines (Writing Committee to Revise the 2001 Guidelines for the Management of Patients With Atrial Fibrillation): Developed in Collaboration With the European Heart Rhythm Association and the Heart Rhythm Society. Circulation 114: 700-752 [Full text]
Authors/Task Force Members, , Fuster, V., Ryden, L. E., Cannom, D. S., Crijns, H. J., Curtis, A. B., Ellenbogen, K. A., Halperin, J. L., Le Heuzey, J.-Y., Kay, G. N., Lowe, J. E., Olsson, S. B., Prystowsky, E. N., Tamargo, J. L., Wann, S., ESC Committee for Practice Guidelines, , Priori, S. G., Blanc, J.-J., Budaj, A., Camm, A. J., Dean, V., Deckers, J. W., Despres, C., Dickstein, K., Lekakis, J., McGregor, K., Metra, M., Morais, J., Osterspey, A., Tamargo, J. L., Zamorano, J. L., ACC/AHA (Practice Guidelines) Task Force Members, , Smith, S. C. Jr, Jacobs, A. K., Adams, C. D., Anderson, J. L., Antman, E. M., Halperin, J. L., Hunt, S. A., Nishimura, R., Ornato, J. P., Page, R. L., Riegel, B. (2006). ACC/AHA/ESC 2006 guidelines for the management of patients with atrial fibrillation executive summary: A report of the American College of Cardiology/American Heart Association Task Force on practice guidelines and the European Society of Cardiology Committee for Practice Guidelines (Writing Committee to Revise the 2001 Guidelines for the Management of Patients with Atrial Fibrillation) Developed in collaboration with the European Heart Rhythm Association and the Heart Rhythm Society. Eur Heart J 27: 1979-2030 [Full text]
Zhang, H., Thijs, L., Staessen, J. A. (2006). Blood Pressure Lowering for Primary and Secondary Prevention of Stroke. Hypertension 48: 187-195 [Full text]
Khachaturian, A. S., Zandi, P. P., Lyketsos, C. G., Hayden, K. M., Skoog, I., Norton, M. C., Tschanz, J. T., Mayer, L. S., Welsh-Bohmer, K. A., Breitner, J. C. S., for the Cache County Study Group, (2006). Antihypertensive Medication Use and Incident Alzheimer Disease: The Cache County Study. Arch Neurol 63: 686-692 [Abstract] [Full text]
Feringa, H. H.H., van Waning, V. H., Bax, J. J., Elhendy, A., Boersma, E., Schouten, O., Galal, W., Vidakovic, R. V., Tangelder, M. J., Poldermans, D. (2006). Cardioprotective Medication Is Associated With Improved Survival in Patients With Peripheral Arterial Disease. J Am Coll Cardiol 47: 1182-1187 [Abstract] [Full text]
Williams, B. (2005). Recent hypertension trials: Implications and controversies. J Am Coll Cardiol 45: 813-827 [Abstract] [Full text]
Sattler, K. J.E., Woodrum, J. E., Galili, O., Olson, M., Samee, S., Meyer, F. B., Zhu, X.-Y., Lerman, L. O., Lerman, A. (2005). Concurrent Treatment With Renin-Angiotensin System Blockers and Acetylsalicylic Acid Reduces Nuclear Factor {kappa}B Activation and C-Reactive Protein Expression in Human Carotid Artery Plaques. Stroke 36: 14-20 [Abstract] [Full text]
Attia, J., D'Este, C., Levi, C. R (2004). The PROGRESS trial three years later: HOPE trial may shed some light. BMJ 329: 1403-1404 [Full text]
Pedelty, L., Gorelick, P. B. (2004). Chronic Management of Blood Pressure After Stroke. Hypertension 44: 1-5 [Full text]
Spence, J. D. (2004). Preventing Dementia by Treating Hypertension and Preventing Stroke. Hypertension 44: 20-21 [Full text]
Field, K. M., Pepin, J. L., Mehta, M. D. (2004). Knowing When to Play the Ace: The Use and Under Use of Ace Inhibitors in Primary Practice. Journal of Pharmacy Practice 17: 197-210 [Abstract]
Lawes, C. M.M., Bennett, D. A., Feigin, V. L., Rodgers, A. (2004). Blood Pressure and Stroke: An Overview of Published Reviews. Stroke 35: 1024-1033 [Abstract] [Full text]
Stenman, E., Edvinsson, L. (2004). Cerebral Ischemia Enhances Vascular Angiotensin AT1 Receptor-Mediated Contraction in Rats. Stroke 35: 970-974 [Abstract] [Full text]
O'Rourke, F., Dean, N., Akhtar, N., Shuaib, A. (2004). Current and future concepts in stroke prevention. CMAJ 170: 1123-1133 [Abstract] [Full text]
Lawes, C. M.M., Bennett, D. A., Feigin, V. L., Rodgers, A. (2004). Blood Pressure and Stroke: An Overview of Published Reviews. Stroke 0: 01.STR.0000126208.14181.D-1033 [Abstract] [Full text]
Lawes, C. M.M., Bennett, D. A., Feigin, V. L., Rodgers, A. (2004). Blood Pressure and Stroke: An Overview of Published Reviews. Stroke 35: 776-785 [Abstract] [Full text]
Marre, M., Lievre, M., Chatellier, G., Mann, J. F E, Passa, P., Menard, J. (2004). Effects of low dose ramipril on cardiovascular and renal outcomes in patients with type 2 diabetes and raised excretion of urinary albumin: randomised, double blind, placebo controlled trial (the DIABHYCAR study). BMJ 328: 495- [Abstract] [Full text]
Muir, K. W (2004). Secondary prevention for stroke and transient ischaemic attacks. BMJ 328: 297-298 [Full text]
Fisher, M., Davalos, A. (2004). Emerging Therapies for Cerebrovascular Disorders. Stroke 35: 367-369 [Full text]
Knapp, M. (2004). Timing of drug treatment is crucial. BMJ 328: 167-167 [Full text]
Felberg, R. A. (2004). Editorial Comment--The MOST Score: Modifying the Open-Artery "Good"-Closed-Artery "Bad" Approach to Thrombolysis Prognosis. Stroke 35: 156-157 [Full text]
Stollberger, C., Slany, J., Brainin, M., Finsterer, J. (2003). Angiotensin-Converting Enzyme Inhibitors and Stroke Prevention: What About the Influence of Atrial Fibrillation and Antithrombotic Therapy?. Stroke 34 : e208-e208 [Full text]
De Schryver, E.L.L.M. (2003). Dipyridamole in Stroke Prevention: Effect of Dipyridamole on Blood Pressure. Stroke 34: 2339-2342 [Abstract] [Full text]
Taylor, R. (2003). Conundrum of the HOPE study: Time of taking ramipril may account for lack of relation between blood pressure and outcome. BMJ 327: 681-682 [Full text]
Ruiz, J. P., Medina, L. M., Parra, F. M., de la Higuera Torres-Puchol, J. M., MacWalter, R. S., Wong, S. Y.S., Wong, K. Y.K., Struthers, A. D. (2003). Stroke Prevention: Indapamide, a Forgotten Option? * Response. Stroke 34 : e156-e157 [Full text]
Sleight, P. (2003). PPOGRESS beyond HOPE and LIFE: The ONTARGET trial programme. Eur Heart J Suppl 5: F40-F47 [Abstract]
Vermes, E., Tardif, J.-C., Bourassa, M. G., Racine, N., Levesque, S., White, M., Guerra, P. G., Ducharme, A. (2003). Enalapril Decreases the Incidence of Atrial Fibrillation in Patients With Left Ventricular Dysfunction: Insight From the Studies Of Left Ventricular Dysfunction (SOLVD) Trials. Circulation 107: 2926-2931 [Abstract] [Full text]
Gerzanich, V., Ivanova, S., Zhou, H., Simard, J. M. (2003). Mislocalization of eNOS and Upregulation of Cerebral Vascular Ca2+ Channel Activity in Angiotensin-Hypertension. Hypertension 41: 1124-1130 [Abstract] [Full text]
MacMahon, S., Chalmers, J. (2003). Blood pressure lowering and ACE inhibition for the avoidance of cardiac and cerebral events. Eur Heart J 24: 391-393 [Full text]
PROGRESS Collaborative Group, (2003). Effects of a perindopril-based blood pressure lowering regimen on cardiac outcomes among patients with cerebrovascular disease. Eur Heart J 24: 475-484 [Abstract] [Full text]
Hankey, G. J. (2003). Angiotensin-Converting Enzyme Inhibitors for Stroke Prevention: Is There HOPE for PROGRESS After LIFE?. Stroke 34: 354-356 [Full text]
Williams, B. (2003). Drug treatment of hypertension. BMJ 326: 61-62 [Full text]
Yusuf, S., Bosch, J., Sleight, P. (2003). Preventing stroke with ramipril---authors' reply. BMJ 326: 52-52 [Full text]
(2003). OTHER ARTICLES NOTED (Nov 01 to 18 Oct 02). Evid. Based Nurs. 6: e1-1 [Full text]
Lonn, E., Gerstein, H.C., Smieja, M., Mann, J.F.E., Yusuf, S. (2003). Mechanisms of cardiovascular risk reduction with ramipril: insights from HOPE and HOPE substudies. Eur Heart J Suppl 5: A43-A48 [Abstract]
Appelros, P., Nydevik, I., Viitanen, M. (2003). Poor Outcome After First-Ever Stroke: Predictors for Death, Dependency, and Recurrent Stroke Within the First Year. Stroke 34: 122-126 [Abstract] [Full text]
Badrinath, P, Wakeman, A. P, Wakeman, J. G, Yudkin, J. S, Parmar, M. S, Twisselmann, B. (2002). Preventing stroke with ramipril. BMJ 325: 439-439 [Full text]
Macleod, J., Mant, J., McLaren, H. (2002). Doctors' self rating of skills in evidence based medicine. BMJ 325: 280-280 [Full text]
(2002). Does Ramipril Prevent Stroke and Stroke-Related Disability?. JWatch Neurology 2002: 1-1 [Full text]
(2002). Stroke Prevention with ACE Inhibitors. Journal Watch Cardiology 2002: 2-2 [Full text]
(2002). Ramipril Prevents Strokes. JWatch General 2002: 7-7 [Full text]
Schrader, J., Luders, S. (2002). Preventing stroke. BMJ 324: 687-688 [Full text]

Rapid Responses:

Read all Rapid Responses

Ramipril and all cause mortality: Trevor D Thompson
bmj.com, 23 Mar 2002 [Full text]
Ramipril and stroke: statistical subtleties matter: Adam Sandell
bmj.com, 23 Mar 2002 [Full text]
Ramipiril works, but does it help my patient with a T. I. A. or a stroke?: W.A.J. Hoefnagels, et al.
bmj.com, 23 Mar 2002 [Full text]
NNT too high to make routine use of Ramipril viable in primary care: John P Coffin
bmj.com, 25 Mar 2002 [Full text]
Is ramipril really organoprotective?: John S Yudkin
bmj.com, 27 Mar 2002 [Full text]
Preventing stroke with ramipril: The fine points.: Malvinder S. Parmar
bmj.com, 27 Mar 2002 [Full text]
Wonky data.: paul nederlof
bmj.com, 27 Mar 2002 [Full text]
Omitting Adverse Effects Data Paints a Rosier Picture: Yoon K Loke
bmj.com, 3 Apr 2002 [Full text]
Ramipril and stroke - Does the way of presenting results matter?: Padmanabhan Badrinath
bmj.com, 8 Apr 2002 [Full text]
Authors' statements are misleading and not supported by data: Mark Campbell, et al.
bmj.com, 10 Apr 2002 [Full text]
What about the influence of atrial fibrillation on the ramipril effect in the HOPE-study?: Claudia St�llberger, et al.
bmj.com, 12 Apr 2002 [Full text]
These results have not been put in the proper perspective: Farokh Buhariwalla, et al.
bmj.com, 2 May 2002 [Full text]
stroke protective effect of angiotensin-II through non-AT1-receptors activation: Albert FOURNIER, et al.
bmj.com, 1 Jun 2002 [Full text]
Lessons learned from the ramipril study: Lesley J Morrison, et al.
bmj.com, 20 Jun 2002 [Full text]
Use of ramipril in preventing stroke: FOURNIER Albert, et al.
bmj.com, 20 Jun 2002 [Full text]
A trial's entire data-set should be publically available: Jeffrey Mann
bmj.com, 29 Aug 2002 [Full text]