Table 2.

Trials Comparing Angiotensin-Converting Enzyme Inhibitors/Angiotensin Receptor Blockers with Placebo in Patients at High Risk of Cardiovascular Events*

TrialYearType of Patient (n)Years of Follow-up (n)ACEI DosageARB DosageEntry BP (mm Hg)Mean BP Reduction (mm Hg)Primary EndpointRelative Risk95% CIP
HOPE262000High risk (n = 9297)5Ramipril, 10 mg139/793/2§MI, stroke, CV death0.780.70–0.86<.001
PROGRESS272001Stroke/TIA (n = 2561)3.9Perindopril, 4 mg147/865/3Stroke0.950.81–1.23NS
EUROPA282003IHD (n = 12,218)4.2Perindopril, 8 mg137/825/2CV death, MI, cardiac arrest0.800.71–0.91.0003
CAMELOT292004IHD (n = 1328)2Enalapril, 20 mg129/786/3CV events0.850.67–1.07NS
PEACE302004IHD (n = 8290)4.8Trandolapril, 4 mg133/783/1CV death, MI, revascularization0.960.88–1.06NS
JIKEI312007High risk (n = 3081)3.1Valsartan, 40–160 mg139/811/1CV morbidity/mortality0.610.47–0.79.0002
TRANSCEND322008High risk (n = 5926)4.7Telmisartan, 80 mg141/824/2CV death, MI, Stroke, CCF hospitalization0.920.81–1.05NS
PROFESS332008Stroke (n = 20,332)2.5Telmisartan, 80 mg144/844/2Stroke0.950.86–1.04NS
  • * These trials do not consistently produce a significant reduction of clinical primary end point.

  • As compared with placebo.

  • Results of patients only on perindopril (single drug) compared with placebo.

  • § HOPE substudy: Mean 24-hr BP reduction vs placebo, 10/4; P = .03. Mean nighttime BP reduction vs placebo, 17/8; P < .001.

  • Results of patients on enalapril compared with placebo.

  • Mean BP reduction vs placebo at 6 months, SBP 2.1 (P = .0005); DBP 2.1 (P < .0001). Mean BP reduction vs placebo at 1 year, SBP 1.5 (P = .0034); DBP 1.3 (P = .0003).

  • TIA, transient ischemic attack; IHD, ischemic heart disease; ACEI, angiotensin-converting enzyme inhibitor; BP, blood pressure; MI, myocardial infarction; CV, cardiovascular; ARB, angiotensin receptor blocker; CCF, congestive cardiac failure; NS, not significant; HOPE, Heart Outcomes Prevention Evaluation; PROGRESS, Perindopril Protection Against Recurrent Stroke Study; EUROPA, European Trial on Reduction of Cardiac Events with Perindopril in Stable Coronary Artery Disease; CAMELOT, Comparison of Arnlodipine vs Enalapril to Limit Occurrences of Thrombosis Trial; PEACE, Prevention of Events with ACEIs Trial; JIKEI, Jikei Heart Study; TRANCSCEND, Telmisartan Randomised Assessment Study in ACE-Intolerant Subjects with Cardiovascular Disease; PROFESS, Prevention Regimen for Effectively Avoiding Second Strokes Trial.