title: New clinical concepts after the ONTARGET trial.
abstract: Some aspects of the Ongoing Telmisartan Alone and in Combination with Ramipril Global Endpoint Trial (ONTARGET) study are briefly commented on in this article. The three main topics of interest related to the study that require further analysis are the following: the influence of blood pressure control, and in particular, the target blood pressure for patients with established cardiovascular disease such as those admitted in the ONTARGET study, the renal aspects of the study, which are of great interest but do not adequately clarify, in particular, concerns over the dual blockade of the renin-angiotensin-aldosterone system (RAAS) with telmisartan and ramipril, and finally, and probably most importantly, the role of statins in the outcome of the study. A high percentage of patients receiving this type of therapy at the end of the study, which probably contributed to obtaining a residual risk similar to that in the Heart Outcomes Prevention Evaluation (HOPE) study in the absence of treatment with RAAS blockers in approximately two-thirds of patients included in the ONTARGET trial.
authors.affiliation: Hypertension Unit, Hospital 12 de Octubre, Avda de Cordoba, s/n 28041, Madrid, Spain. ruilope@ad-hocbox.com
authors.forename: Luis M
authors.initials: LM
authors.lastname: Ruilope
authors.forename: Julian
authors.initials: J
authors.lastname: Segura
authors.forename: Jose L
authors.initials: JL
authors.lastname: Zamorano
mesh_terms: D047228:Angiotensin II Type 1 Receptor Blockers / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use; D001562:Benzimidazoles / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D001565:Benzoates / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects; D002318:Cardiovascular Diseases / Q000188:drug therapy* / Q000503:physiopathology; D002986:Clinical Trials as Topic; D004359:Drug Therapy, Combination; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use; D006973:Hypertension / Q000188:drug therapy; D017257:Ramipril / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D000077333:Telmisartan
chemical_list: D047228:Angiotensin II Type 1 Receptor Blockers; D000806:Angiotensin-Converting Enzyme Inhibitors; D001562:Benzimidazoles; D001565:Benzoates; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D017257:Ramipril; D000077333:Telmisartan