Can ACE Inhibitors Prevent Diabetes?

In the industry-sponsored Heart Outcomes Prevention Evaluation (HOPE) study, diabetic and nondiabetic patients at high cardiovascular risk (but without LV dysfunction or heart failure) were randomized to receive either the ACE inhibitor ramipril or placebo. Ramipril recipients suffered fewer adverse cardiovascular and renal events than did placebo recipients, regardless of diabetes status.

In this substudy, investigators analyzed data on new diabetes diagnoses among initially nondiabetic HOPE subjects (5720 patients); mean follow-up was 4.5 years. Self-reported diabetic status was confirmed by levels of hemoglobin A_1c and medication-use data. During follow-up, 102 initially nondiabetic ramipril recipients (3.6 percent) and 155 initially nond…