BMJ  2003;327:682 (20 September), doi:10.1136/bmj.327.7416.682

Letter

Conundrum of the HOPE study

Authors' reply

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

EDITOR—Taylor speculates that the reason that the HOPE (heart outcomes prevention evaluation) study did not show a significant relation between blood pressure and outcome was because ramipril was taken at bedtime.1

We believe that this assertion is incorrect for several reasons.

Firstly, the population studied in the paper by Svensson et al differed substantially from the overall HOPE population.2 This substudy focused on 38 patients who had peripheral arterial disease whereas only 43% of the overall HOPE population had such disease. Moreover, the patients recruited from the one centre participating in this substudy had blood pressures that were appreciably different from those in the overall trial (150/79 mm Hg v 139/79 mm Hg).

Secondly, even if a blood pressure reduction were extrapolated from the substudy by Svensson et al (which we believe is not appropriate), the degree of blood pressure reduction may at most be underestimated by 40%. . . . [Full text of this article]

J Bosch, assistant clinical professor

jackie@ccc.mcmaster.ca

S Yusuf, professor of medicine

McMaster University, 237 Barton Street East, Hamilton, ON, Canada L8L 2X2


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Relevant Article

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]

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