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Stroke Prevention in People with Diabetes

By HospiMedica staff writers
Posted on 11 Jan 2001
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A large trial involving 3,500 patients who had diabetes plus at least one other cardiovascular risk factor has shown that patients who took the drug ramipril along with other therapies for cardiovascular disease (aspirin, lipid-lowering agents, or beta blockers) reduced the risk of stroke by 33%, the risk of heart attack by 22%, and the risk of cardiovascular death by 37%. The study was called HOPE (Heart Outcomes Prevention Evaluation).

As a result of these findings, new guidelines issued by the Stroke Council of the American Heart Association and published in the January issue of Circulation recommend the use of ramipril in at-risk people with diabetes. Ramipril (Altace, Wyeth-Ayerst Laboratories) is an angiotensin converting enzyme (ACE) inhibitor. Although cardiovascular disease is the leading killer of people with diabetes, many people with the disease are not aware of the link and are missing the benefits of available preventive therapies such as ramipril.

"The incidence of diabetes greatly increases with age,” notes Dr. Jeffrey Probstfield, professor of medicine, University of Washington, and investigator of the HOPE study. "Because the risk of cardiovascular disease also increases with age, the threat of cardiovascular disease should be a particular concern for older adults with diabetes.”



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