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Related Experiment Videos

The ONTARGET/TRANSCEND Trial Programme: baseline data.

P Sleight1

  • 1Department of Cardiovascular Medicine, Level 5, John Radcliffe Hospital University of Oxford, UK. peter.sleight@cardiov.ox.ac.uk

Acta Diabetologica
|May 4, 2005
PubMed
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Cardiovascular risk is high, but new trials compare angiotensin II receptor blockers (ARBs) and ACE inhibitors for heart protection. These studies assess if these drugs offer benefits beyond blood pressure control in high-risk patients.

Area of Science:

  • Cardiology
  • Pharmacology
  • Clinical Trials

Background:

  • Cardiovascular disease (CVD) risk is multifactorial, increasing morbidity and mortality.
  • Current CVD risk management relies on global risk assessment and combination therapies.
  • Angiotensin-converting enzyme (ACE) inhibitors and angiotensin II receptor blockers (ARBs) target multiple CVD risk factors, potentially offering blood pressure-independent benefits.

Purpose of the Study:

  • To evaluate the blood pressure-independent cardioprotective effects of an ARB (telmisartan) versus an ACE inhibitor (ramipril) or their combination in high-risk patients.
  • To compare telmisartan with placebo in patients intolerant to ACE inhibitors for cardiovascular outcomes.

Main Methods:

  • The ONgoing Telmisartan Alone and in combination with Ramipril Global Endpoint Trial (ONTARGET) randomized 25,620 patients.

Related Experiment Videos

  • The Telmisartan Randomized AssessmeNt Study in ACE iNtolerant subjects with cardiovascular Disease (TRANSCEND) randomized 5,926 patients.
  • Both trials used a composite endpoint of cardiovascular death, non-fatal myocardial infarction, non-fatal stroke, or heart failure hospitalization.

    • Main Results:

    • Recruitment for both ONTARGET and TRANSCEND trials is complete.
    • Patient populations in ONTARGET/TRANSCEND exhibit greater ethnic diversity than the HOPE study.
    • Participants are older, with well-controlled, slightly lower mean blood pressure than in HOPE, and higher use of beta-blockers and lipid-lowering therapy.

    Conclusions:

    • These large-scale trials represent significant comparisons of ARB and ACE inhibitor therapies in high-risk, controlled blood pressure populations.
    • Results are anticipated to significantly influence future cardiovascular disease treatment strategies.
    • The studies aim to clarify the role of ARBs and ACE inhibitors in cardioprotection beyond blood pressure reduction.