passages: 687
passages: document
passages: Development of renal disease in people at high cardiovascular risk : results of the HOPE randomized study . In people with diabetes , renal disease tends to progress from microalbuminuria to clinical proteinuria to renal insufficiency . Little evidence has been published for the nondiabetic population . This study retrospectively analyzed changes of proteinuria over 4.5 yr in the HOPE ( Heart Outcomes and Prevention Evaluation ) study , which compared ramipril 's effects to placebo in 9297 participants , including 3577 with diabetes and 1956 with microalbuminuria . This report is restricted to 7674 participants with albuminuria data at baseline and at follow-up . Inclusion criteria were known vascular disease or diabetes plus one other cardiovascular risk factor , exclusion criteria included heart failure or known impaired left ventricular function , dipstick-positive proteinuria ( > 1+ ) , and serum creatinine > 2.3 mg/dl ( 200 microM ) . Baseline microalbuminuria predicted subsequent clinical proteinuria for the study participants overall ( adjusted odds ratio [ OR ] , 17.5 ; 95 % confidence interval [ CI ] , 12.6 to 24.4 ) , in participants without diabetes ( OR , 16.7 ; 95 % CI , 8.6 to 32.4 ) , and in participants with diabetes ( OR , 18.2 ; 95 % CI , 12.4 to 26.7 ) . Any progression of albuminuria ( defined as new microalbuminuria or new clinical proteinuria ) occurred in 1859 participants ; 1542 developed new microalbuminuria , and 317 participants developed clinical proteinuria . Ramipril reduced the risk for any progression ( OR , 0.87 ; 95 % CI , 0.78 to 0.97 ; P = 0.0146 ) . People without and with diabetes who are at high risk for cardiovascular disease are also at risk for a progressive rise in albuminuria . Microalbuminuria itself predicts clinical proteinuria in nondiabetic and in diabetic people . Ramipril prevents or delays the progression of albuminuria .
entities: 688
entities: Intervention_Pharmacological
entities: ramipril 's
entities: 689
entities: Intervention_Control
entities: placebo
entities: 690
entities: Intervention_Pharmacological
entities: Ramipril
entities: 691
entities: Intervention_Pharmacological
entities: Ramipril
entities: 692
entities: Outcome_Physical
entities: clinical proteinuria
entities: 693
entities: Outcome_Physical
entities: progression of albuminuria
entities: 694
entities: Outcome_Physical
entities: microalbuminuria
entities: 695
entities: Outcome_Physical
entities: clinical proteinuria .
entities: 696
entities: Outcome_Physical
entities: progression
entities: 697
entities: Outcome_Physical
entities: albuminuria .
entities: 698
entities: Outcome_Physical
entities: progression of albuminuria .
entities: 699
entities: Participant_Condition
entities: people at high cardiovascular risk
entities: 700
entities: Participant_Condition
entities: people with diabetes
entities: 701
entities: Participant_Sample-size
entities: 7674
entities: 702
entities: Participant_Condition
entities: participants with albuminuria data at baseline and at follow-up
entities: 703
entities: Participant_Condition
entities: nondiabetic and in diabetic people .