BMJ  2004;328 (28 February), doi:10.1136/bmj.328.7438.0-c

Low dose ramipril is not optimal in diabetes

Low dose (1.25 mg daily) ramipril does not reduce cardiovascular and renal events in patients with type 2 diabetes and albuminuria. After four years of follow up of 4912 diabetic patients enrolled in the DIABHYCAR trial, where participants were given low dose ramipril or standard care, Marre and colleagues (p 495) found that low dose ramipril had no effect on cardiovascular and renal outcome, but it slightly reduced albuminuria and blood pressure in the intervention group. The protective effect of ramipril may be dose dependent, the authors say, and high doses can be recommended for cardiovascular protection in high risk patients.

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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)

Michel Marre, Michel Lievre, Gilles Chatellier, Johannes F E Mann, Philippe Passa, and Joël Ménard
BMJ 2004 328: 495. [Abstract] [Full Text] [PDF]