ABSTRACT
The four RCTs comparing ACEIs against placebo involved patients whose primary problem was coronary disease and not hypertension. The largest by far, the Heart Outcomes Prevention Evaluation (HOPE) trial (2000), included 4355 hypertensive patients, but most were on other antihypertensive drugs and the average blood pressure of the entire 9297 patient population at entry into the trial was only 139/79 mmHg. Despite only a 3/1 mmHg further lowering of BP, significant reductions in all major end-points were seen in those given the ACEI ramipril.
