CoChat
Sign Up
Cited by 324Peripheral Artery Disease ManagementCardiovascular Health and Disease PreventionBlood Pressure and Hypertension Studies

Impact of ramipril in patients with evidence of clinical or subclinical peripheral arterial disease

Östergren, J·2004·European Heart Journal
DOI 10.1016/j.ehj.2003.10.033
Open this paper in CoChat — free account

Abstract

AIMS: The aim of this study was to assess the prognostic importance of peripheral arterial disease (PAD) as evaluated by ankle blood pressure index (ABI), and the impact of ramipril on the prevention of major cardiovascular events in PAD patients included in the Heart Outcomes Prevention Evaluation (HOPE) study. METHODS AND RESULTS: Patients were randomized to treatment with ramipril or placebo and followed for 4.5 years. Ankle brachial blood pressure index was measured, mainly by digital palpation of the foot pulse, at baseline in 8986 patients. The ABI was subnormal (< or =0.9) in 3099 patients and normal in 5887 patients. A low ABI was a strong predictor of morbidity and mortality during the follow-up even in patients with no clinical symptoms of PAD (n=6769). This was so for the primary outcome of the study; ABI>0.9:13.1%, 0.6-0.9: 18.2% and <0.6: 18.0% (P<0.0001) and for mortality from all causes: in those with a normal ABI it was 8.5%, in those with ABI >0.6-0.9, 12.4% and 14.2% in those with an ABI lower than 0.6 (P<0.0001). Ramipril reduced the risk of clinical outcomes in those with a clinical history of PAD as well as in the patients with subclinical PAD. CONCLUSIONS: The ABI even if measured simply by palpation of the foot arteries is a strong predictor for future cardiovascular events and for all-cause mortality. Ramipril prevented major cardiovascular events in patients with clinical as well as subclinical PAD.

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.1016/j.ehj.2003.10.033

Cites

22 of 22 references verified0 citation errors · 0 not checkable

Statistics

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Cites

Flagged first, then by citations

Research works printed but not linked: 2

  1. [4]4. O ¨gren M, Hedblad B, Jungquist G et al. Low ankle-brachial pressure index in 68-year old men. Prevalence, risk factors and prognosis. Eur J Vasc Surg 1993;7:500-6.
  2. [8]8. CAPRIE steering committee. A randomized, blinded, trial of clopi- dogrel versus aspirin in patients at risk of ischaemic events. Lancet 1996;345:1329-39.

Cited by

Sorted by citations

Related

Authors
Östergren, J.
Affiliations
Karolinska University Hospital (SE)
Corresponding author
Östergren, J
ORCID
Östergren, J
Venue
European Heart Journal
Publisher
Oxford University Press (OUP)
Published
2004-01
Volume
25
Issue
1
Pages
17-24
ISSN
0195-668X (ISSN-L)
DOI
10.1016/j.ehj.2003.10.033
OpenAlex
W2160999195
Semantic Scholar
378ae9dc75d87d2cc5fbff13174e390395f4a215
Cited by
324
References
22
Citations by year
2026: 4 · 2025: 11 · 2024: 8 · 2023: 13 · 2022: 11 · 2021: 18 · 2020: 11 · 2019: 9 · 2018: 12 · 2017: 18 · 2016: 14 · 2015: 5 · 2014: 7 · 2013: 21 · 2012: 21
FWCI
16.66
Type
journal article
Language
en
Open access
closed
Locations
  • European Heart Journal (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • Heart and Stroke Foundation of Canada
  • Medical Research Council Canada
  • Medical Research Council
Topics
  • Health Sciences › Medicine › Surgery › Peripheral Artery Disease Management
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Disease Prevention
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
Keywords
ramipril, peripheral arterial disease, ankle-brachial index, cardiovascular risk prediction, all-cause mortality, major cardiovascular events, ACE inhibitors
MeSH terms
Aged, Angiotensin-Converting Enzyme Inhibitors, Ankle, Arteries, Blood Pressure, Brachial Artery, Female, Follow-Up Studies, Humans, Male, Middle Aged, Single-Blind Method, Peripheral Vascular Diseases, Treatment Outcome, Ramipril

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review