Renal outcomes with telmisartan, ramipril, or both, in people at high vascular risk (the ONTARGET study): a multicentre, randomised, double-blind, controlled trial

Lancet
Johannes F E MannONTARGET investigators

Abstract

Angiotensin receptor blockers (ARB) and angiotensin converting enzyme (ACE) inhibitors are known to reduce proteinuria. Their combination might be more effective than either treatment alone, but long-term data for comparative changes in renal function are not available. We investigated the renal effects of ramipril (an ACE inhibitor), telmisartan (an ARB), and their combination in patients aged 55 years or older with established atherosclerotic vascular disease or with diabetes with end-organ damage. The trial ran from 2001 to 2007. After a 3-week run-in period, 25 620 participants were randomly assigned to ramipril 10 mg a day (n=8576), telmisartan 80 mg a day (n=8542), or to a combination of both drugs (n=8502; median follow-up was 56 months), and renal function and proteinuria were measured. The primary renal outcome was a composite of dialysis, doubling of serum creatinine, and death. Analysis was by intention to treat. This study is registered with ClinicalTrials.gov, number NCT00153101. 784 patients permanently discontinued randomised therapy during the trial because of hypotensive symptoms (406 on combination therapy, 149 on ramipril, and 229 on telmisartan). The number of events for the composite primary outcome was sim...Continue Reading

References

Jul 31, 2001·JAMA : the Journal of the American Medical Association·H C GersteinUNKNOWN HOPE Study Investigators
Sep 22, 2001·The New England Journal of Medicine·E J LewisUNKNOWN Collaborative Study Group
Sep 22, 2001·The New England Journal of Medicine·B M BrennerUNKNOWN RENAAL Study Investigators
Mar 26, 2002·Journal of the American Society of Nephrology : JASN·Karl F Hilgers, Johannes F E Mann
Oct 29, 2003·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·Johannes F E MannUNKNOWN HOPE Investigators
Nov 2, 2004·The New England Journal of Medicine·Anthony H BarnettUNKNOWN Diabetics Exposed to Telmisartan and Enalapril Study Group
Feb 3, 2006·The Journal of Clinical Investigation·Giuseppe RemuzziAndrea Remuzzi
Jun 9, 2006·The New England Journal of Medicine·Lesley A StevensAndrew S Levey
Apr 2, 2008·The New England Journal of Medicine·UNKNOWN ONTARGET InvestigatorsCraig Anderson
May 13, 2008·Lancet·Regina KunzJohannes F E Mann
Sep 9, 2008·Current Hypertension Reports·Donald G Vidt

❮ Previous
Next ❯

Citations

Mar 31, 2010·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·Kevin V Lemley
May 22, 2010·Cardiovascular Drugs and Therapy·Christian W Mende
Mar 20, 2009·International Urology and Nephrology·Yasmin PashaDavid Goldsmith
Jul 25, 2012·International Urology and Nephrology·Vipin VermaSteven R Gambert
Oct 19, 2011·Journal of General Internal Medicine·Emaad M Abdel-RahmanAlaa S Awad
Aug 12, 2009·Current Atherosclerosis Reports·Jan Basile
Jan 15, 2011·Current Atherosclerosis Reports·Gianpaolo ReboldiPaolo Verdecchia
Oct 30, 2009·Current Cardiology Reports·Roberto PisoniDavid A Calhoun
Jun 10, 2010·Current Diabetes Reports·Raimund H Pichler, Ian H de Boer
May 31, 2012·Current Diabetes Reports·Anil Karihaloo
Apr 25, 2012·Current Heart Failure Reports·Gabriel WagmanTimothy J Vittorio
Sep 10, 2009·Current Hypertension Reports·Marion R Wofford, Deborah S Minor
Sep 10, 2009·Current Hypertension Reports·Ranjan Chanda, Andrew Z Fenves
Sep 10, 2009·Current Hypertension Reports·Sheldon W Tobe, Monica O Dai
Sep 10, 2009·Current Hypertension Reports·Radica Z AlicicKatherine R Tuttle
Sep 10, 2009·Current Hypertension Reports·Kunal ChaudharyAdam Whaley-Connell
Aug 10, 2010·Current Hypertension Reports·Giovanna LeonciniRoberto Pontremoli
Nov 26, 2010·Current Hypertension Reports·Ulrich M BecherNikos Werner
Jun 5, 2012·Current Hypertension Reports·Jennifer B Cowart, Addison A Taylor
Nov 20, 2012·Current Hypertension Reports·Jiandong Zhang, Steven D Crowley
Oct 5, 2013·High Blood Pressure & Cardiovascular Prevention : the Official Journal of the Italian Society of Hypertension·Francesca ViazziRoberto Pontremoli
May 7, 2009·The Canadian Journal of Cardiology·Nadia A KhanUNKNOWN Canadian Hypertension Education Program
Jul 29, 2011·Hypertension Research : Official Journal of the Japanese Society of Hypertension·Naoki NakagawaUNKNOWN NICE-Combi Study Group
Aug 13, 2011·Hypertension Research : Official Journal of the Japanese Society of Hypertension·Yasutomi HigashikuniMasataka Sata
Aug 24, 2012·Hypertension Research : Official Journal of the Japanese Society of Hypertension·Tasuku NagasawaSadayoshi Ito
Oct 12, 2012·Hypertension Research : Official Journal of the Japanese Society of Hypertension·Anastasia G PtinopoulouAnastasios N Lasaridis
Nov 5, 2008·Nature Clinical Practice. Nephrology·Murray Epstein
Apr 9, 2009·Nature Reviews. Cardiology·Varun AgrawalPeter A McCullough
Oct 9, 2013·Nature Reviews. Endocrinology·Daniel FinebergMark E Cooper
Jul 30, 2009·Nature Reviews. Nephrology·Piero Ruggenenti, Giuseppe Remuzzi
Sep 30, 2009·Nature Reviews. Nephrology·M Khaled Shamseddin, Patrick S Parfrey
Apr 23, 2009·Nature Reviews. Nephrology·Diana Rucker, Marcello Tonelli
May 21, 2009·Nature Reviews. Nephrology·Eswari Vilayur, David C H Harris
Mar 30, 2010·Nature Reviews. Nephrology·Takahiko Nakagawa
May 5, 2010·Nature Reviews. Nephrology·Anne-Emilie Declèves, Kumar Sharma
May 5, 2010·Nature Reviews. Nephrology·Piero RuggenentiGiuseppe Remuzzi
Jun 22, 2011·Nature Reviews. Nephrology·Elke Wühl, Franz Schaefer
Dec 19, 2012·Nature Reviews. Nephrology·Hiddo J Lambers HeerspinkGerjan J Navis
Mar 7, 2012·Nature Reviews. Nephrology·Aliza Thompson
Oct 9, 2013·Nature Reviews. Nephrology·Suetonia C Palmer, Giovanni F M Strippoli

❮ Previous
Next ❯

Related Concepts

Related Feeds

Atherosclerosis Disease Progression

Atherosclerosis is the buildup of plaque on artery walls, causing stenosis which can eventually lead to clinically apparent cardiovascular disease. Find the latest research on atherosclerosis disease progression here.

Anthelmintics

Anthelmintics or antihelminthics are a group of antiparasitic drugs that expel parasitic worms (helminths) and other internal parasites from the body by either stunning or killing them and without causing significant damage to the host. Discover the latest research on anthelmintics here.

Cardiovascular Disease Pathophysiology

Cardiovascular disease involves several different processes that contribute to the pathological mechanism, including hyperglycemia, inflammation, atherosclerosis, hypertension and more. Vasculature stability plays a critical role in the development of the disease. Discover the latest research on cardiovascular disease pathophysiology here.

Antihypertensive Agents: Mechanisms of Action

Antihypertensive drugs are used to treat hypertension (high blood pressure) which aims to prevent the complications of high blood pressure, such as stroke and myocardial infarction. Discover the latest research on antihypertensive drugs and their mechanism of action here.