Results from a landmark study have shown that the ACE inhibitor ramipril prevents major cardiovascular events in patients with a history of vascular disease or diabetes mellitus. The Heart Outcomes Prevention Evaluation (HOPE) trial showed that ramipril reduces the risk of cardiovascular mortality, stroke or myocardial infarction (MI) by 22% in this patient group. Results were presented at the 21st Congress of the European Society of Cardiology [Barcelona, Spain; August-September 1999], where HOPE investigators said that the study represents one of the greatest discoveries in heart disease treatment worldwide.