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Telmisartan, ramipril, or both in high-risk Chinese patients: analysis of ONTARGET China data.

Abstract

BACKGROUND

The results from the ONgoing Telmisartan Alone and in combination with Ramipril Global Endpoint Trial (ONTARGET) indicated that the angiotensin-receptor blocker telmisartan was not inferior to the angiotensin-converting-enzyme inhibitor ramipril in reducing the composite endpoint of cardiovascular death, myocardial infarction, stroke or hospitalization for congestive heart failure in high-risk patients, and telmisartan was associated with slightly superior tolerability. The combination of the two drugs was associated with more adverse events without an increase in benefit. This study aimed to analyze the data from ONTARGET obtained from a subgroup of patients enrolled in China and to evaluate the demographic and baseline characteristics, the compliance, efficacy, and safety of the different treatment strategies in randomized patients in China.

METHODS

A total of 1159 high-risk patients were randomized into three treatment groups: with 390 assigned to receive 80 mg of telmisartan, 385 assigned to receive 10 mg of ramipril and 384 assigned to receive both study medications. The median follow-up period was 4.3 years.

RESULTS

The mean age of Chinese patients was 65.6 years, 73.6% of patients were male. The proportion of patients with stroke/transient ischemic attacks at baseline in China was two times more than the entire study population (47.7% vs. 20.9%). In Chinese patients the proportion of permanent discontinuation of study medication due to cough was 0.5% in the telmisartan group, which was much less than that in the combination or the ramipril group. There were no significant differences in the incidence of primary outcome among three treatment groups of Chinese patients. More strokes occurred in Chinese patients than in the entire study population (8.5% vs. 4.5%). Greater systolic blood pressure reduction (-9.8 mmHg), and more renal function failure were noted in the combination treatment group than in the ramipril or telmisartan group (2.6% vs. 1.6% and 1.0%).

CONCLUSIONS

There was no evidence that the results of ONTARGET differed between Chinese patients and the entire study population with respect to the incidence of primary outcome, particularly safety. Compliance with study medications was good. The evidence from ONTARGET indicated that the treatment strategies in ONTARGET were applicable to patients in China.

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  • Authors+Show Affiliations

    ,

    Emergency Center, Cardiovascular Institute and Fuwai Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing 100037, China.

    , , , ,

    Source

    Chinese medical journal 124:12 2011 Jun pg 1763-8

    MeSH

    Aged
    Angiotensin II Type 1 Receptor Blockers
    Angiotensin-Converting Enzyme Inhibitors
    Benzimidazoles
    Benzoates
    China
    Drug Therapy, Combination
    Female
    Heart Failure
    Humans
    Male
    Middle Aged
    Ramipril
    Telmisartan

    Pub Type(s)

    Journal Article
    Randomized Controlled Trial

    Language

    eng

    PubMed ID

    21740829

    Citation

    Yu, Li-Tian, et al. "Telmisartan, Ramipril, or Both in High-risk Chinese Patients: Analysis of ONTARGET China Data." Chinese Medical Journal, vol. 124, no. 12, 2011, pp. 1763-8.
    Yu LT, Zhu J, Tan HQ, et al. Telmisartan, ramipril, or both in high-risk Chinese patients: analysis of ONTARGET China data. Chin Med J. 2011;124(12):1763-8.
    Yu, L. T., Zhu, J., Tan, H. Q., Wang, G. G., Teo, K. K., & Liu, L. S. (2011). Telmisartan, ramipril, or both in high-risk Chinese patients: analysis of ONTARGET China data. Chinese Medical Journal, 124(12), pp. 1763-8.
    Yu LT, et al. Telmisartan, Ramipril, or Both in High-risk Chinese Patients: Analysis of ONTARGET China Data. Chin Med J. 2011;124(12):1763-8. PubMed PMID: 21740829.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Telmisartan, ramipril, or both in high-risk Chinese patients: analysis of ONTARGET China data. AU - Yu,Li-Tian, AU - Zhu,Jun, AU - Tan,Hui-Qiong, AU - Wang,Guo-Gan, AU - Teo,Koon K, AU - Liu,Li-Sheng, PY - 2011/7/12/entrez PY - 2011/7/12/pubmed PY - 2011/12/13/medline SP - 1763 EP - 8 JF - Chinese medical journal JO - Chin. Med. J. VL - 124 IS - 12 N2 - BACKGROUND: The results from the ONgoing Telmisartan Alone and in combination with Ramipril Global Endpoint Trial (ONTARGET) indicated that the angiotensin-receptor blocker telmisartan was not inferior to the angiotensin-converting-enzyme inhibitor ramipril in reducing the composite endpoint of cardiovascular death, myocardial infarction, stroke or hospitalization for congestive heart failure in high-risk patients, and telmisartan was associated with slightly superior tolerability. The combination of the two drugs was associated with more adverse events without an increase in benefit. This study aimed to analyze the data from ONTARGET obtained from a subgroup of patients enrolled in China and to evaluate the demographic and baseline characteristics, the compliance, efficacy, and safety of the different treatment strategies in randomized patients in China. METHODS: A total of 1159 high-risk patients were randomized into three treatment groups: with 390 assigned to receive 80 mg of telmisartan, 385 assigned to receive 10 mg of ramipril and 384 assigned to receive both study medications. The median follow-up period was 4.3 years. RESULTS: The mean age of Chinese patients was 65.6 years, 73.6% of patients were male. The proportion of patients with stroke/transient ischemic attacks at baseline in China was two times more than the entire study population (47.7% vs. 20.9%). In Chinese patients the proportion of permanent discontinuation of study medication due to cough was 0.5% in the telmisartan group, which was much less than that in the combination or the ramipril group. There were no significant differences in the incidence of primary outcome among three treatment groups of Chinese patients. More strokes occurred in Chinese patients than in the entire study population (8.5% vs. 4.5%). Greater systolic blood pressure reduction (-9.8 mmHg), and more renal function failure were noted in the combination treatment group than in the ramipril or telmisartan group (2.6% vs. 1.6% and 1.0%). CONCLUSIONS: There was no evidence that the results of ONTARGET differed between Chinese patients and the entire study population with respect to the incidence of primary outcome, particularly safety. Compliance with study medications was good. The evidence from ONTARGET indicated that the treatment strategies in ONTARGET were applicable to patients in China. SN - 0366-6999 UR - https://www.unboundmedicine.com/medline/citation/21740829/Telmisartan_ramipril_or_both_in_high_risk_Chinese_patients:_analysis_of_ONTARGET_China_data_ L2 - http://Insights.ovid.com/pubmed?pmid=21740829 DB - PRIME DP - Unbound Medicine ER -