Tags

Type your tag names separated by a space and hit enter

The ongoing telmisartan alone and in combination with ramipril global endpoint trial program.
Am J Cardiol 2003; 91(10A):28G-34GAJ

Abstract

The renin-angiotensin system evolved to maintain volume homeostasis and blood pressure and to prevent ischemia during acute volume loss. But in the present age, these mechanisms are redundant, and the clinical significance of angiotensin II results from its pathologic effects, which are mediated by the angiotensin II type 1 (AT(1)) receptor. Activation of AT(1) receptors has been linked to pathologic processes that contribute to atherosclerosis and ischemic events, including oxidative stress, inflammatory processes, low-density lipoprotein cholesterol trafficking, and prothrombotic states. The Ongoing Telmisartan Alone and in Combination with Ramipril Global Endpoint Trial (ONTARGET) program will compare the efficacy of the angiotensin II receptor blocker (ARB) telmisartan, the angiotensin-converting enzyme (ACE) inhibitor ramipril, and combination therapy with telmisartan plus ramipril for reducing cardiovascular risk. The ARB telmisartan is distinguished by its long duration of action, which compares favorably with some other ARBs and conventional antihypertensives. Ramipril was shown in the Heart Outcomes Prevention Evaluation (HOPE) study to reduce the risk for myocardial infarction (MI) and other cardiovascular events in patients at high risk for cardiovascular events but without heart failure or a low ejection fraction. The ONTARGET program consists of 2 randomized, double-blind, multicenter international trials: a principal trial, ONTARGET, and a parallel trial, Telmisartan Randomized Assessment Study in ACE-I Intolerant Patients with Cardiovascular Disease (TRANSCEND). The treatment arms for the principal ONTARGET study are telmisartan 80 mg, ramipril 10 mg, and combination therapy with telmisartan 80 mg plus ramipril 10 mg; for the parallel study TRANSCEND, the treatment arms are telmisartan 80 mg and placebo. Both trials will assess cardiovascular outcomes in patients at high risk using the same criteria as that of the HOPE study, with a single exception: the TRANSCEND trial will enroll patients who do not tolerate ACE inhibitor treatment. The primary end points in both ONTARGET and TRANSCEND are death caused by cardiovascular disease, acute MI, stroke, and hospitalization because of congestive heart failure. The secondary end points include newly diagnosed heart failure, revascularization, new-onset type 2 diabetes mellitus, nephropathy, cognitive decrease and dementia, and newly diagnosed atrial fibrillation; these will be used for hypothesis generation.

Authors+Show Affiliations

Institute of Pharmacology and Toxicology, Charité Hospital, Humboldt University at Berlin, Berlin, Germany. Thomas.unger@charite.de

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

12781906

Citation

Unger, Thomas. "The Ongoing Telmisartan Alone and in Combination With Ramipril Global Endpoint Trial Program." The American Journal of Cardiology, vol. 91, no. 10A, 2003, 28G-34G.
Unger T. The ongoing telmisartan alone and in combination with ramipril global endpoint trial program. Am J Cardiol. 2003;91(10A):28G-34G.
Unger, T. (2003). The ongoing telmisartan alone and in combination with ramipril global endpoint trial program. The American Journal of Cardiology, 91(10A), 28G-34G.
Unger T. The Ongoing Telmisartan Alone and in Combination With Ramipril Global Endpoint Trial Program. Am J Cardiol. 2003 May 22;91(10A):28G-34G. PubMed PMID: 12781906.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The ongoing telmisartan alone and in combination with ramipril global endpoint trial program. A1 - Unger,Thomas, PY - 2003/6/5/pubmed PY - 2003/7/10/medline PY - 2003/6/5/entrez SP - 28G EP - 34G JF - The American journal of cardiology JO - Am. J. Cardiol. VL - 91 IS - 10A N2 - The renin-angiotensin system evolved to maintain volume homeostasis and blood pressure and to prevent ischemia during acute volume loss. But in the present age, these mechanisms are redundant, and the clinical significance of angiotensin II results from its pathologic effects, which are mediated by the angiotensin II type 1 (AT(1)) receptor. Activation of AT(1) receptors has been linked to pathologic processes that contribute to atherosclerosis and ischemic events, including oxidative stress, inflammatory processes, low-density lipoprotein cholesterol trafficking, and prothrombotic states. The Ongoing Telmisartan Alone and in Combination with Ramipril Global Endpoint Trial (ONTARGET) program will compare the efficacy of the angiotensin II receptor blocker (ARB) telmisartan, the angiotensin-converting enzyme (ACE) inhibitor ramipril, and combination therapy with telmisartan plus ramipril for reducing cardiovascular risk. The ARB telmisartan is distinguished by its long duration of action, which compares favorably with some other ARBs and conventional antihypertensives. Ramipril was shown in the Heart Outcomes Prevention Evaluation (HOPE) study to reduce the risk for myocardial infarction (MI) and other cardiovascular events in patients at high risk for cardiovascular events but without heart failure or a low ejection fraction. The ONTARGET program consists of 2 randomized, double-blind, multicenter international trials: a principal trial, ONTARGET, and a parallel trial, Telmisartan Randomized Assessment Study in ACE-I Intolerant Patients with Cardiovascular Disease (TRANSCEND). The treatment arms for the principal ONTARGET study are telmisartan 80 mg, ramipril 10 mg, and combination therapy with telmisartan 80 mg plus ramipril 10 mg; for the parallel study TRANSCEND, the treatment arms are telmisartan 80 mg and placebo. Both trials will assess cardiovascular outcomes in patients at high risk using the same criteria as that of the HOPE study, with a single exception: the TRANSCEND trial will enroll patients who do not tolerate ACE inhibitor treatment. The primary end points in both ONTARGET and TRANSCEND are death caused by cardiovascular disease, acute MI, stroke, and hospitalization because of congestive heart failure. The secondary end points include newly diagnosed heart failure, revascularization, new-onset type 2 diabetes mellitus, nephropathy, cognitive decrease and dementia, and newly diagnosed atrial fibrillation; these will be used for hypothesis generation. SN - 0002-9149 UR - https://www.unboundmedicine.com/medline/citation/12781906/The_ongoing_telmisartan_alone_and_in_combination_with_ramipril_global_endpoint_trial_program_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0002914903002303 DB - PRIME DP - Unbound Medicine ER -