Ramipril use in HOPE trial reduced new diabetes diagnoses
Patients in the Heart Outcomes Prevention Evaluation
(HOPE) trial who ended up taking the angiotensin converting enzyme inhibitor
ramipril had a lower rate of being newly diagnosed with diabetes, according
to a sub-analysis of the study.
Of 9,541 patients who took part in the HOPE trial,
5,720 did not have a clinical diagnosis of diabetes at the start of the
trial. Researchers found that 3.6 per cent of the patients receiving up
to 10mg of ramipril daily reported a new diagnosis of diabetes compared
with 5.4 per cent of the patients receiving placebo (relative risk 0.66,
95 per cent confidence interval 0.51-0.85, P<0.001). The researchers
assessed whether the lower occurrence of cardiovascular events and diabetic
nephropathy in patients receiving ramipril decreased the likelihood of
them developing diabetes. However, they say that the impact of ramipril
could not be explained by confounding factors.
The researchers warn that the results of the sub-analysis
should be interpreted with caution, but they conclude that the results
could have important implications and should be confirmed by a prospective
study (JAMA 2001;286:1882).
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