A large-scale clinical trial of the ACE inhibitor ramipril has earlier been reported to significantly improve heart outcomes in people at high risk for cardiovascular events. The trial, known as the Heart Outcomes Prevention Evaluation, or HOPE, included more than 9,500 patients in 267 hospitals and 19 countries. Patients received ramipril, vitamin E, or placebo for a 5-year period.

An evaluation of a subgroup of 3,578 of the trial participants who had diabetes has shown a significant reduction - 24% - in the primary outcome measure, which was a combination of heart attack, stroke, or death from cardiovascular causes. In addition, fewer patients in the overall population had a new diagnosis of diabetes, and fewer in the ramipril group had diabetic complications.

The authors concluded that the use of ramipril significantly lowers the rates of death, myocardial infarction, stroke, revascularization, cardiac arrest, and heart failure. It also reduces complications related to diabetes and reduces new cases of diabetes in patients at high risk for cardiovascular events. Lifeclinic.com advisor Dr. David McCulloch points out that all ACE inhibitors no doubt have the same benefits.