Cardiovascular Drugs and Therapy

, Volume 19, Issue 3, pp 197–201 | Cite as

The HOPE TIPS: The HOPE Study Translated into Practices

Clinical Trials


The HOPE TIPS study assessed the practicality and tolerability of ramipril titration to a target dose of 10 mg (as achieved in definitive efficacy studies) in a clinical practice setting. 3881 patients at high cardiovascular risk (HOPE study criteria) were recruited in primary and specialist care settings in 9 countries by 439 investigators. Dose titration of ramipril from 2.5 mg to 10 mg daily took place over 9–12 weeks. The mean age of the patients was 64 years, 60% were male and 79% Asian. The target dosage of 10 mg daily was reached in 73% of patients with 96% of patients achieving 5 mg or 10 mg daily. During the study period uncontrolled hypertension (> 160/90) was recorded in 15% of patients, myocardial infarction or unstable angina 1.6%, heart failure 0.4%, new diabetes 0.6%. Only 9.8% of patients discontinued treatment with 5.9% attributed to treatment side-effects and 4% related to cough. The large majority of patients in a wide range of clinical practice settings with high cardiovascular risk can be treated with ramipril titrated to 10 mg daily with good tolerability.


cardiovascular risk diabetes ramipril 


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  1. 1.
    Murray CJL, Lopez AD, eds. The global burden of disease: A comprehensive assessment of mortality and disability from diseases, injuries, and risk factors in 1990 and projected to 2020. Boston: Harvard School of Public Health, 1996.Google Scholar
  2. 2.
    Yusuf S, Hawken S, Ôunpuu S, et al. Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): Case-control study. Lancet 2004;364:937–953.CrossRefPubMedGoogle Scholar
  3. 3.
    Third Joint Task Force of the European and other Societies. European guidelines on cardiovascular disease prevention in clinical practice. New Euro J CV Prev and Rehab 2003;10(Suppl 1):S11–S78.Google Scholar
  4. 4.
    New Zealand Guidelines Group. The Assessment and Management of Cardiovascular Risk. December 2003.Google Scholar
  5. 5.
    Heart Outcomes Prevention Evaluation (HOPE) study investigators. Effects of an angiotensin converting-enzyme inhibitor, ramipril, on cardiovascular events in high-risk patients. N Engl J Med 2000;342:145–153.Google Scholar
  6. 6.
    Fox KM. Efficacy of perindopril in reduction of cardiovascular events among patients with stable coronary heart disease: Randomised, double-blind, placebo-controlled, multicentre trial (the EUROPA study). Lancet 2003;362:782–788.CrossRefPubMedGoogle Scholar
  7. 7.
    The PEACE Trial Investigators. Angiotensin converting-enzyme inhibition in stable coronary artery disease. N Engl J Med 2004; 351:2058–2068.Google Scholar
  8. 8.
    Antithrombotic Trialists’ Collaboration, Collaborative meta-analysis of randomised trials of antiplatelet therapy for prevention of death, myocardial infarction and stroke in high risk patients. BMJ 2002;324:71–86.Google Scholar
  9. 9.
    Yusuf S, Peto R, Lewis J, et al. Beta-blockade during and after myocardial infarction: An overview of the randomised trials. Prog Cardiovasc Dis 1985;27:335–371.PubMedGoogle Scholar
  10. 10.
    Scandinavian Simvastatin Survival Study Group. Randomised trial of cholesterol lowering in 4,444 patients with coronary heart disease: The Scandinavian Simvastatin Survival (4S) Study. Lancet 1994;334:1383–1389.Google Scholar
  11. 11.
    Yusuf S, Clinical, public health and research implications of the Heart Outcomes Prevention Evaluation (HOPE) study. Eur Heart J 2001;22:103–104.CrossRefPubMedGoogle Scholar
  12. 12.
    Sharpe N. Matching the standards of clinical trial evidence with application in practice. Int J Clin Pract 2002;56:772–775.PubMedGoogle Scholar
  13. 13.
    Kaplan NM. The CARE study, a postmarketing evaluation of ramipril in 11,100 patients. Clin Ther 1996;18:658–670.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science + Business Media, Inc. 2005

Authors and Affiliations

  1. 1.University of AucklandGreenlaneNew Zealand

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