New clinical concepts after the ONTARGET trial

Area of Science:

• Cardiology
• Pharmacology
• Nephrology

Background:

• The Ongoing Telmisartan Alone and in Combination with Ramipril Global Endpoint Trial (ONTARGET) investigated cardiovascular outcomes.
• Established cardiovascular disease patients were analyzed for treatment effects.

Purpose of the Study:

• To analyze the ONTARGET study's findings on blood pressure control targets in cardiovascular patients.
• To clarify the renal aspects and dual blockade of the renin-angiotensin-aldosterone system (RAAS) with telmisartan and ramipril.
• To determine the role of statins in the study's outcomes.

Main Methods:

• Review and commentary on the ONTARGET study data.
• Analysis of blood pressure control, renal effects, and RAAS blockade.
• Evaluation of statin therapy's impact on patient outcomes.

Main Results:

• The study requires further analysis regarding optimal blood pressure targets for cardiovascular patients.
• Renal aspects and concerns over dual RAAS blockade by telmisartan and ramipril need clarification.
• High statin use at study's end likely contributed to residual risk reduction.

Conclusions:

• Further investigation into blood pressure targets and RAAS blockade is warranted.
• The role of statins in mitigating residual cardiovascular risk in the ONTARGET population is significant.
• ONTARGET findings highlight the complex interplay of therapies in cardiovascular disease management.