Clinical evidence from ONTARGET: proven cardio- and vascular protection
Why the study?
Does telmisartan alone or in combination with ramipril reduce cardiovascular events compared to ramipril alone in patients with vascular disease or high-risk diabetes without heart failure?
Structured PICO
Does telmisartan alone or in combination with ramipril reduce cardiovascular events compared to ramipril alone in patients with vascular disease or high-risk diabetes without heart failure?
P
Population
Patients with vascular disease or high-risk diabetes without heart failure, who are tolerant to ACE inhibitors
I
Intervention
Telmisartan alone, or telmisartan in combination with ramipril
C
Comparator
Ramipril alone
O
Outcome
Composite of cardiovascular death, myocardial infarction, stroke, or hospitalization for heart failurecomposite
Telmisartan is non-inferior to ramipril for cardiovascular protection in high-risk patients, but combining both agents increases adverse events without added benefit.
Authors
Discussion
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Implication
Telmisartan remains a noninferior option to ramipril in high-risk patients without HF; leaves open whether dual RAS blockade benefits narrower subgroups.
Cite This Study
Koon Teo (2009) studied this question.