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Published on: September 26, 2018

Evolving treatment options for prevention of cardiovascular events in high-risk hypertensive patients

Prakash Deedwania1

  • 1Cardiology Division, VACCHS/University of California, San Francisco, Fresno, CA 93703, USA. deed1@sbcglobal.net

Journal of Clinical Hypertension (Greenwich, Conn.)
|November 6, 2007
PubMed

Insights

Identifying and treating high-risk cardiovascular disease patients reduces mortality. Angiotensin-converting enzyme (ACE) inhibitors or angiotensin receptor blockers (ARBs) are effective, with combination therapy potentially offering greater cardioprotection in hypertensive individuals.

Area of Science:

  • Cardiology
  • Pharmacology
  • Hypertension Management

Background:

  • Cardiovascular disease (CVD) poses significant morbidity and mortality risks.
  • Hypertension management is crucial, with risk factors including dyslipidemia, smoking, obesity, coronary heart disease, peripheral arterial disease, cerebrovascular/carotid artery disease, and diabetes.
  • Various drug classes, including ACE inhibitors and ARBs, are used to reduce cardiovascular events in hypertensive patients.

Purpose of the Study:

  • To evaluate the cardioprotective effects of combination therapy with an ACE inhibitor and an ARB.
  • To assess the efficacy of telmisartan (ARB) in combination with ramipril (ACE inhibitor) in high-risk patients.

Main Methods:

  • The study involves high-risk patients with hypertension.
  • Investigational drugs include ramipril (an ACE inhibitor) and telmisartan (an ARB).
  • The Ongoing Telmisartan Alone and in Combination With Ramipril Global Endpoint Trial (ONTARGET) is a key clinical trial.

Main Results:

  • ACE inhibitors and ARBs, often with diuretics, effectively reduce cardiovascular events, particularly in diabetic patients.
  • Both ACE inhibitors and ARBs target the renin-angiotensin-aldosterone system via distinct mechanisms.
  • Combination therapy with ACE inhibitors and ARBs is being investigated for enhanced efficacy.

Conclusions:

  • Identifying and treating high-risk individuals is vital for reducing cardiovascular morbidity and mortality.
  • ACE inhibitors and ARBs are established treatments for hypertensive patients.
  • Further research, such as the ONTARGET trial, is evaluating the benefits of combining ACE inhibitors and ARBs for improved cardiovascular outcomes.

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