ONTARGET for Hypertension or Not?

摘要

Introduction: The Heart Outcomes Prevention Evaluation (HOPE) trial demonstrated the benefits of treating patients at high risk for cardiovascular morbidity and mortality with an angiotensin I-converting enzyme (ACE) inhibitor, ramipril. The angiotensin II receptor blockers (ARBs) perturb the renin-angiotensin system (RAS) by a mechanism different from the ACE inhibitors. Thus, it was not known whether ARBs would have the same beneficial effect in individuals at high risk for cardiovascular events. Finally, it was also not known if a combination of an ACE inhibitor and an ARB would confer additional benefit to that seen with each class alone. To answer these questions, the Ongoing Telmisartan Alone and in Combination with Ramipril Global End-point Trial (ONTARGET) was initiated.