Data and Commentary:The HOPE Study
• Effects of angiotensin-converting enzyme inhibition on cardiovascular events in high-risk patients
The Heart Outcomes Prevention Evaluation Study Investigators.
N Engl J Med. 2000; 342:145-153.
With Commentary by
Carl J. Pepine, MD
University of Florida College of Medicine
This discourse is offered as a continuing medical education program from the University of Florida College of Medicine.
The Heart Outcomes Prevention Evaluation (HOPE) Study was a landmark clinical evaluation of tissue angiotensin-converting enzyme inhibition. Because of the potential clinical implications, the main findings from this trial were released by the New England Journal of Medicine prior to publication. This final report has now been published, and we are pleased to include a reprint and accompanying commentary.
The success of the HOPE Study can be understood in the context of endothelial dysfunction present in patients with readily identifiable risk factors of elevated lipids, hypertension, and diabetes mellitus. All of these risk factors can contribute to the development and progression of atherosclerosis and its unwanted sequelae of myocardioal ischemia, infarction, heart failure, and death. Indeed, one of the postulated mechanisms of the beneficial effects of HOPE may be the improvement in endothelial function seen in earlier trials.
This CME program is part of a series of educational programs aimed at taking the mystery out of vascular biology and making it relevant to patient care.