ONTARGET Investigators. Telmisartan, ramipril, or both in patients at high risk for vascular events. N Engl J Med. 2008;358(15):1547-59.
Objective: To compare the ACE inhibitor ramipril, the ARB telmisartan, and the combination of the two drugs in patients with vascular disease or high-risk diabetes.
Methods: In this double-blind study (N=24,000+), patients were randomized to receive 10 mg of ramipril per day, 80 mg of telmisartan per day, or both drugs (combination therapy). The primary composite outcome was death from cardiovascular causes, myocardial infarction, stroke, or hospitalization for heart failure.
Results: 0.3% of patients in the ramipril group experienced angioedema compared to 0.1% of patients in the the telmisartan group.