6/28/23, 11:44 PM ONTARGET (telmisartan with ramipril) Pathway Feedback Search Clinical Topics Home Studies ONTARGET (telmisartan with ramipril) ONTARGET (telmisartan with ramipril) Disease Disease Disease Acute ischemic stroke Coronary artery disease Diabetes m Trial question Is a combination of telmisartan and ramipril superior to ramipril in patients with vascular disease or high-risk diabetes? Study design Multi-center Double blinded RCT Population Characteristics of study participants 27.0% female N = 17078 73.0% male 17078 patients (4581 female, 12497 male) Inclusion criteria: patients with vascular disease or high-risk diabetes without HF Key exclusion criteria: known hypersensitivity or intolerance to angiotensin 2 receptor antagonist or angiotensin-converting enzyme; symptomatic congestive HF; renal artery stenosis; hepatic dysfunction Interventions N=8502 combination therapy (80 mg telmisartan and 10 mg ramipril per day) N=8576 ramipril (at a dose of 10 mg per day) Primary outcome https://web.pathway.md/studies/recc9MykBIaoyWr1q 1/2 6/28/23, 11:44 PM ONTARGET (telmisartan with ramipril) Pathway Composite of death from cardiovascular causes, myocardial infarction, stroke or hospitalization for heart failure 16.5 % 16.5 16.3 12.4 % 8.3 % 4.1 % No significant difference 0.0 % Combination therapy Ramipril No significant difference in composite of death from cardiovascular causes, myocardial infarction, stroke or hospitalization for HF (16.3% vs. 16.5%; RR 0.99, 99% CI 0.92 to 1.07) Secondary outcomes No significant difference in revascularization (15.3% vs. 14.8%; RR 1.04, 95% CI 0.97 to 1.13) No significant difference in hospitalization for angina (11.2% vs. 10.8%; RR 1.04, 95% CI 0.95 to 1.14) Significant increase in renal impairment (13.5% vs. 10.2%; RR 1.33, 95% CI 1.22 to 1.44) Safety outcomes No significant difference in angioedema and cough. Significant differences in hypotensive symptoms (4.8% vs. 1.7%), syncope (0.3% vs. 0.2%). Conclusion In patients with vascular disease or high-risk diabetes without HF, combination therapy was not superior to ramipril with respect to the composite of death from cardiovascular causes, myocardial infarction, stroke or hospitalization for HF. Reference ONTARGET Investigators, Yusuf S, Teo KK et al. Telmisartan, ramipril, or both in patients at high risk for vascular events. N Engl J Med. 2008 Apr 10;358(15):1547-59. Open reference URL https://web.pathway.md/studies/recc9MykBIaoyWr1q 2/2