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Telmisartan and ramipril were equivalent, but their combination increased adverse events in vascular disease or diabetes

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S Yusuf

Dr S Yusuf, Hamilton Health Sciences, Hamilton, Ontario, Canada; yusufs@mcmaster.ca

STUDY DESIGN

Design:

randomised controlled trial (ONgoing Telmisartan Alone and in combination with Ramipril Global Endpoint Trial [ONTARGET]).

Allocation:

concealed.*

Blinding:

blinded (patients, clinicians, and outcome assessors).*

STUDY QUESTION

Setting:

733 centres in 40 countries.

Patients:

25 620 patients ⩾55 years of age (mean age 66 y, 73% men) who had coronary or peripheral artery disease, cerebrovascular disease, or diabetes with end-organ damage. Exclusion criteria included intolerance to or inability to discontinue angiotensin-converting enzyme (ACE) inhibitors or angiotensin-receptor blockers (ARBs), and congestive heart failure (HF).

Intervention:

telmisartan, 80 mg/day (n = 8542); ramipril, 5 mg/day in the first 2 weeks, …

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