Aras Vs Iecas
Páginas: 2 (268 palabras)
Publicado: 3 de octubre de 2012
new england journal of medicine
The
established in 1812
april 10, 2008
vol. 358
no. 15
Telmisartan, Ramipril, or Both in Patients at High Risk forVascular Events
The ONTARGET Investigators*
A bs t r ac t
Background
In patients who have vascular disease or high-risk diabetes without heart failure,angiotensin-converting–enzyme (ACE) inhibitors reduce mortality and morbidity from cardiovascular causes, but the role of angiotensin-receptor blockers (ARBs) in suchpatients is unknown. We compared the ACE inhibitor ramipril, the ARB telmisartan, and the combination of the two drugs in patients with vascular disease or high-riskdiabetes.
Methods
After a 3-week, single-blind run-in period, patients underwent double-blind randomization, with 8576 assigned to receive 10 mg of ramipril perday, 8542 assigned to receive 80 mg of telmisartan per day, and 8502 assigned to receive both drugs (combination therapy). The primary composite outcome was deathfrom cardiovascular causes, myocardial infarction, stroke, or hospitalization for heart failure.
Results
Mean blood pressure was lower in both the telmisartangroup (a 0.9/0.6 mm Hg greater reduction) and the combination-therapy group (a 2.4/1.4 mm Hg greater reduction) than in the ramipril group. At a median follow-up of56 months, the primary outcome had occurred in 1412 patients in the ramipril group (16.5%), as compared with 1423 patients in the telmisartan group (16.7%; relativerisk, 1.01; 95% confidence interval [CI], 0.94 to 1.09). As compared with the ramipril group, the telmisartan group had lower rates of cough (1.1% vs. 4.2%, P
The
established in 1812
april 10, 2008
vol. 358
no. 15
Telmisartan, Ramipril, or Both in Patients at High Risk forVascular Events
The ONTARGET Investigators*
A bs t r ac t
Background
In patients who have vascular disease or high-risk diabetes without heart failure,angiotensin-converting–enzyme (ACE) inhibitors reduce mortality and morbidity from cardiovascular causes, but the role of angiotensin-receptor blockers (ARBs) in suchpatients is unknown. We compared the ACE inhibitor ramipril, the ARB telmisartan, and the combination of the two drugs in patients with vascular disease or high-riskdiabetes.
Methods
After a 3-week, single-blind run-in period, patients underwent double-blind randomization, with 8576 assigned to receive 10 mg of ramipril perday, 8542 assigned to receive 80 mg of telmisartan per day, and 8502 assigned to receive both drugs (combination therapy). The primary composite outcome was deathfrom cardiovascular causes, myocardial infarction, stroke, or hospitalization for heart failure.
Results
Mean blood pressure was lower in both the telmisartangroup (a 0.9/0.6 mm Hg greater reduction) and the combination-therapy group (a 2.4/1.4 mm Hg greater reduction) than in the ramipril group. At a median follow-up of56 months, the primary outcome had occurred in 1412 patients in the ramipril group (16.5%), as compared with 1423 patients in the telmisartan group (16.7%; relativerisk, 1.01; 95% confidence interval [CI], 0.94 to 1.09). As compared with the ramipril group, the telmisartan group had lower rates of cough (1.1% vs. 4.2%, P
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