Hope studies

Heart Outcomes Prevention Evaluation Study Investigators. Effects of ramipril on cardiovascular and mi-crovascular outcomes in people with diabetes melli-tus results of the HOPE study and MICRO-HOPE substudy. Lancet 2000 355 253-9. 

The Heart Outcomes Prevention Evaluation (HOPE) Study Investigators (2000). Lancet 355, 253-259. 

ACE inhibitors reduce morbidity and mortality post myocardial infarction in patients with left ventricular systolic dysfunction (LVSD). This is thought to be mediated via their action on the renin-angiotensin system. More recent evidence from the HOPE study (2000) has established that ACE inhibitors given to high risk CVD patients who had not got low ejection fraction or heart failure resulted in benefits in terms of reduced morbidity and mortality. 

Within the HOPE study ramipril was the agent of choice and this would be an appropriate ACE inhibitor to use post-myocardial infarction. Ramipril is licensed for use post myocardial infarction at a dose of 2.5 mg twice daily initially (started in hospital 3-10 days after infarction), increased after 2 days to 5 mg twice daily. Maintenance doses are 2.5 mg-5 mg twice daily. 

Anon. Effects of ramipril on cardiovascular and microvas-cular outcomes in people with diabetes meUitus Results of the hope study and micro-hope substudy. Heart outcomes prevention evaluation study investigators. Lancet. 2000 355 253-259... 

Although this total synthesis concludes our presentation of this intriguing natural product, the final chapter of its exploration is certainly far from written. Many new synthetic tools and strategies are still needed to provide more efficient solutions to the vancomycin architecture, and a wealth of fundamental knowledge in the area of chemical biology remains to be discovered. Hopefully, studies aimed in this latter direction will not only reveal new insight into... 

Heart Outcomes Prevention Evaluation Study Investigators (2000) Effects of ramipril on cardiovascular and microvascular outcomes in people with diabetes meUitus results of the HOPE study and MICRO-HOPE substudy. Lancet 355 253-259 Hurwitz H, Fehrenbacher L, Novotny W et al (2004) Bevacizumab plus irinotecan, fluorouracil, and leucovorin for metastatic colorectal cancer. N Engl J Med 350 2335-2342 Kozloff M, Yood MU, Berlin J et al (2009) Clinical outcomes associated with bevacizumab-containing treatment of metastatic colorectal cancer the BRiTE observational cohort study. Oncologist 14 862-870... 

O Brien and Turner (2013) commented on this case study as follows The HOPE study was designed to prove the beneficial effect of a drug on cardiovascular outcome, and were it not for the ambulatory blood pressure monitoring study, the... 

There are discordant results between the effects of vitamin E supplements in observational studies, in which they seem to reduce the risk of cardiovascular disease, and the results of interventional studies, in which they seem to have the opposite effect. In an extensive review of the benefits and adverse effects of vitamin E, the authors, employees of IdeaSphere Inc., which markets vitamins and nutrients, concluded that healthy consumers should not change their current use of vitamin E supplements since most of the studies included in the three recent neutral to unfavorable meta-analyses were not conducted on free-living healthy individuals. .. [and] only four of 28 studies included in these meta-analyses involved healthy individuals [45 ]. They urged that the guidelines set forth by the Institute of Medicine [in 2000] should still be embraced and that healthy individuals should not use more than 1000 mg of vitamin E daily . They concurred with the findings of the HOPE study, a randomized, placebo-controlled study of the use of vitamin E 400 lU/day over 7 years [46 ], that vitamin E did not prevent cancer or major cardiovascular disease events in subjects with pre-existing vascular disease or diabetes mellitus, and may have increased the risk of heart failure, and that, as the authors of the HOPE study concluded, such individuals should be warned to beware of natural products . 

The ability of a-tocopherol supplementation to prevent cardiovascular events in different populations was tested in four larger prospective clinical trials The a-Tocopherol, yS-Carotene Cancer Prevention (ATBC) study, the Cambridge Heart Antioxidant Study (CHAOS), the Gruppo Italiano per lo studio della Sopravvivenza nell Infarto Miocar-dito (GISSI) trial, and the Heart Outcome Prevention Evaluation (HOPE) study. In addition, at least two smaller prospective clinical trials have been completed the Secondary Prevention with... 

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