Reader Remarks on:

ACE Inhibition for Preventing Diabetes: Still Just a DREAM

Was ramipril dosed QHS as in HOPE trial

Was ramipril dosed QHS as in HOPE trial

Charles Beauchamp, 6 Dec 2011 8:11 AM EST

Competing interests: None declared

Specialty: Internal Medicine

In the HOPE trial ramipril was dosed QHS and it was shown to have a diabetes onset and diabetes complication sparing effect. There are clinicians who believe with some reason that QHS dosing of some anti- hypertensives has better clinical care and clinical prevention effects. The methods of NEJM often just mention that an ACE-I was dosed "daily". This is a fundamental flaw of the Methods explanation in the NEJM and other journals. Even a clinician who did 24 hour BP studies in the HOPE trial showing that ramipril QHS had no significant daytime effects on BP got away with co-authoring the telmesartan - ramipril study without specifying in the methods the time of day of dosing or EVEN whether the telmesartan and ramipril were dosed at the same time in the NEJM!!!!!!! Does anybody at the NEJM realiize that the time of dosing of antihypertensives can have major clinical care nad clinical prevention effects?

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