HOPE 2000

Methods	Country: Canada Setting/Design: Multicentre Time frame: NS Randomisation method: NS Blinding ‐ Participants: Yes ‐ Investigators: Yes ‐ Outcome assessors: Yes ‐ Data analysis: No Intention‐to‐treat: Yes Follow‐up period: mean 4.5 years Loss to follow‐up:13
Participants	Inclusion criteria Patients with and without diabetes aged 55 years or older with a history of cardiovascular disease (coronary artery disease, stroke, or peripheral vascular disease) or diabetes plus at least one other cardiovascular risk factor (total cholesterol > 5.2 mmol/L, HDL cholesterol < 0.9 mmol/L, hypertension, known microalbuminuria, or current smoking) Ramipril group Number: 1808 Age: 65.3 (6.4) Sex (M/F): 1112/636 Placebo group Number: 1769 Age: 65.6 (6.6) Sex (M/F): 1143/626 Exclusion criteria Dipstick‐positive proteinuria or established diabetic nephropathy Other severe renal disease Hyperkalaemia CHF Low ejection fraction (< 0.4) Uncontrolled hypertension Recent MI or stroke (< 4weeks) Use of or hypersensitivity to vitamin E or ACEi
Interventions	Ramipril group 10 mg/d Placebo group Co‐interventions: No
Outcomes	Development of MI, stroke or cardiovascular death Total mortality, admission to hospital for CHFor unstable angina, cardiovascular revascularisation or development of overt nephropathy Any heart failure, worsening angina, and the development of diabetes in people with no history of the disorder Progression of microalbuminuria or overt nephropathy in participants with diabetes
Notes
Risk of bias
Bias	Authors' judgement	Support for judgement
Allocation concealment?	Low risk	A ‐ Adequate