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Lessons learned from the ONTARGET and TRANSCEND trials

Jan Basile1

  • 1Ralph H. Johnson VA Medical Center, Medical University of South Carolina, Charleston, SC 29401, USA. Jan.Basile@med.va.gov

Current Atherosclerosis Reports
|August 12, 2009
PubMed

Insights

Blocking the renin-angiotensin-aldosterone system (RAAS) is crucial for managing hypertension and cardiovascular disease (CVD). Key trials like ONTARGET and TRANSCEND demonstrate the efficacy of RAAS inhibitors in high-risk patients.

Area of Science:

  • Cardiology
  • Pharmacology

Background:

  • Cardiovascular disease (CVD) is a leading cause of death in the US.
  • The renin-angiotensin-aldosterone system (RAAS) plays a significant role in blood pressure regulation and CVD.
  • Targeting the RAAS is a key strategy for treating hypertension and cardiovascular conditions.

Purpose of the Study:

  • To review the outcomes of the ONTARGET and TRANSCEND trials.
  • To discuss the role of RAAS inhibition in managing high-risk cardiovascular patients.
  • To identify clinical practice issues regarding RAAS-targeting therapies.

Main Methods:

  • Analysis of data from the Ongoing Telmisartan Alone and in Combination with Ramipril Global endpoint Trial (ONTARGET).
  • Review of findings from the Telmisartan Randomized Assessment Study in ACE-Intolerant Subjects with Cardiovascular Disease (TRANSCEND).

Main Results:

  • Both trials demonstrated the effectiveness of angiotensin-converting enzyme inhibitors and angiotensin receptor blockers in reducing CVD.
  • Specific outcomes related to telmisartan in combination therapy and in ACE-intolerant patients were highlighted.

Conclusions:

  • RAAS inhibition is a vital therapeutic approach for patients with hypertension and existing CVD.
  • Clinical decisions on selecting RAAS-targeting therapies require careful consideration of trial data and patient profiles.

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