Sc. Jones et al., HOPE for patients with Type 2 diabetes: an application of the findings of the MICRO-HOPE substudy in a British hospital diabetes clinic, DIABET MED, 18(8), 2001, pp. 667-670
Aims The MICRO-HOPE substudy demonstrated that when ramipril treatment was
added to people with Type 2 diabetes and additional cardiovascular risk fac
tors cardiovascular events were reduced by 25% in 4.5 years. We wished to d
etermine the proportion of people with Type 2 diabetes and additional cardi
ovascular risk factors registered with a hospital diabetes service.
Methods Non-proteinuric people (n = 1370) with Type 2 diabetes identified o
n our diabetes register were subject to analysis. Anticipated reductions in
cardiovascular events due to ramipril treatment were based on reductions o
bserved in the MICRO-HOPE substudy.
Results Non-proteinuric people (n = 1075 (78%)) with Type 2 diabetes had at
least one additional cardiovascular risk factor. Twenty-nine percent were
already taking an angiotensin-converting enzyme inhibitor. The remaining 76
4 patients were similar to ramipril-treated participants in the MICRO-HOPE
substudy. Treatment with ramipril for 4.5 years would be anticipated to red
uce cardiovascular deaths by 26, revascularization procedures by 19 and adm
issions for myocardial infarction and stroke by 18 and 26, respectively.
Conclusions Of non-proteinuric people with Type 2 diabetes, 78% have additi
onal cardiovascular risk factors. Only a small proportion currently receive
treatment with an angiotensin-converting enzyme inhibitor. The incidence o
f cardiovascular events could be reduced if more patients were treated with
ramipril and other cardiovascular risk factors were addressed.