Preventing stroke

doi:10.1136/bmj.324.7339.687

BMJ 2002;324:687-688 ( 23 March )

Editorials

Preventing stroke

High risk patients should receive ramipril irrespective of their blood pressure

Papers p 699

The first 150 words of the full text of this article appear below.

The Heart Outcomes Prevention Evaluation study (HOPE), has shown beneficial effects of the angiotensin converting enzyme inhibitorramipril on cardiovascular events and disease progression.¹In this issue the investigators describe the results of preventingstroke (p 699).² The findings clearly show that ramipril substantiallydecreased the risk of stroke and transient ischaemic attacks in9297 patients with high cardiovascular risk. A 32% relative riskreduction was found, while the reduction in blood pressure wasonly 3.8 mm Hg (systolic) and 2.8 mm Hg (diastolic). This benefitwas greater than expected from prior meta-analyses of epidemiologicalstudies or trials in hypertension studies. The results have importantimplications for the primary and secondary prevention ofstroke.

Firstly, it must be emphasised that hypertension is still the most important risk factor for stroke, as shown in all studieson hypertension in recent decades,³ and more recently in thePROGRESS study, in which an average blood . . . [Full text of this article]

CiteULike

Complore

Connotea

Del.icio.us Add to Digg

Digg

StumbleUpon Add to Technorati

Technorati What's this?

Relevant Articles

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]

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

Use of ramipril in preventing stroke: double blind randomised trial: Jackie Bosch, Salim Yusuf, Janice Pogue, Peter Sleight, Eva Lonn, Badrudin Rangoonwala, Richard Davies, Jan Ostergren, and Jeff Probstfield
BMJ 2002 324: 699. [Abstract] [Full Text] [PDF]

This article has been cited by other articles:

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). Ramipril Prevents Strokes. JWatch General 2002: 7-7 [Full text]

Rapid Responses:

Read all Rapid Responses

Are other classes of drugs effective: john sharvill
bmj.com, 25 Mar 2002 [Full text]
Ramipril in stroke prevention: benefits were considerably overstated: Andrew P Wakeman, et al.
bmj.com, 25 Mar 2002 [Full text]
Tolerance of remipril: pervez Asghar, et al.
bmj.com, 26 Mar 2002 [Full text]
Is there HOPE for 2.5mg?: Peter David Burrill
bmj.com, 26 Mar 2002 [Full text]
There are outcome data on A2As in hypertension: FD Richard Hobbs
bmj.com, 22 May 2002 [Full text]