Ruggenenti P, Podestà MA, Trillini M, et al. - Researchers undertook this phase 3, prospective, randomized, open-label, blinded end point, parallel, multicenter trial to assess the cardioprotective impacts of ramipril (angiotensin-converting enzyme inhibitor) among patients receiving maintenance hemodialysis. Participants were recruited from 28 Italian centers and included patients undergoing maintenance hemodialysis with hypertension and/or left ventricular hypertrophy. Between July 2009 and February 2014, a total of 140 patients were randomly assigned to ramipril (1.25–10 mg/d) and overall 129 patients were assigned to non-renin-angiotensin system inhibition therapy, both titrated up to the maximally tolerated dose to attain predefined target BP values. A composite of cardiovascular death, myocardial infarction, or stroke was assessed as the primary efficacy endpoint. Findings showed that no decrease in the risk of major cardiovascular events was conferred by treatment with ramipril in patients receiving maintenance hemodialysis.