The Heart Outcomes Prevention Evaluation (HOPE) Study: Limitations and Strengths

Domenic A. Sica, MD; Division of Clinical Pharmacology and Hypertension, Medical College of Virginia, Virginia Commonwealth University, Richmond, VA.

In This Article

The Micro-Hope Study

The results in the 3577 diabetic subjects in the HOPE study were even more striking than the findings of the main study.[12] However, these findings are most applicable to patients with type II diabetes in that only 81 of the 3577 diabetics in the HOPE study were type I diabetics. There were highly significant risk reductions of 25% for the combined primary outcome, 22% for myocardial infarction, 33% for stroke, and 37% for cardiovascular death. In addition, overt nephropathy was reduced by 24%. As was observed in the main study, the benefits observed were consistent across literally all subgroups and occurred independently of age and gender and regardless of whether patients were taking ß blockers, aspirin, or lipid-lowering agents. The striking findings in the diabetics are not surprising in light of results from the UK Prospective Diabetes Study (UKDPS)[13] and the Hypertension Optimal Treatment (HOT) study,[14] both of which showed a clear cardiovascular benefit of reducing BP.