The ONgoing Telmisartan Alone and in

combination with Ramipril Global Endpoint Trial

ONTARGET

Salim Yusuf, Koon K. Teo, Janice Pogue, Leanne Dyal, aSalim Yusuf, Koon K. Teo, Janice Pogue, Leanne Dyal, a

nd Ingrid Copland, Population Health Research Institutnd Ingrid Copland, Population Health Research Institut

e and Investigatorse and Investigators

Yusuf, et al. N ENGL J MED.358;15:1547-1559

Change in BP (mmHg)Change in BP (mmHg)

RamiprilRamipril TelmisartanTelmisartan CombinationCombination

SystolicSystolic -6.0-6.0 -6.9-6.9 -8.4-8.4

DiastolicDiastolic -4.6-4.6 -5.2-5.2 -6.0-6.0

Yusuf, et al. N ENGL J MED.358;15:1547-1559

ONTARGET

Time to Permanent Discontinuation Time to Permanent Discontinuation of Study Medicationof Study Medication

NO. at RiskNO. at Risk

TelmisartanTelmisartan 85428542 79547954 73847384 69096909 64786478

RamiprilRamipril 85768576 77967796 71657165 66816681 62546254

Years of Follow-upYears of Follow-up

TelmisartanTelmisartan

RamiprilRamipril

Cu

mu

lati

ve H

azar

d R

ates

Cu

mu

lati

ve H

azar

d R

ates

Yusuf, et al. N ENGL J MED.358;15:1547-1559

ONTARGET

Reasons for Permanently Reasons for Permanently Stopping Study MedicationsStopping Study Medications

RamRam

N=8576N=8576

TelTel

N=8542N=8542

Tel vs. RamTel vs. Ram

RR PRR P

HypotensionHypotension 149149 229229 1.541.54 0.00010.0001

SyncopeSyncope 1515 1919 1.271.27 0.48500.4850

CoughCough 360360 9393 0.260.26 <0.0001<0.0001

DiarrheaDiarrhea 1212 1919 1.591.59 0.200.20

AngioedemaAngioedema 2525 1010 0.400.40 0.01150.0115

Renal Renal

ImpairmentImpairment

6060 6868 1.141.14 0.460.46

Any DiscontinuatioAny Discontinuationn

20992099 19621962 0.940.94 0.020.02

Yusuf, et al. N ENGL J MED.358;15:1547-1559

ONTARGET

Time to Primary OutcomeTime to Primary Outcome

TelmisartanTelmisartanRamiprilRamipril

NO. at RiskNO. at Risk

TelmisartanTelmisartan

RamipriRamiprill

Years of Follow-upYears of Follow-up

Cu

mu

lati

ve H

azar

d R

ates

Cu

mu

lati

ve H

azar

d R

ates

85428542 81768176 77787778 74207420 70517051

85768576 82148214 78327832 74737473 70957095

Yusuf, et al. N ENGL J MED.358;15:1547-1559

ONTARGET

Primary Outcome & HOPEPrimary Outcome & HOPE Primary Outcome Primary Outcome

RamRam TelTel Tel vs RamTel vs Ram

N (%)N (%) N (%)N (%) RR (95% CI)RR (95% CI) P (non-inf)P (non-inf)

NN 85768576 85428542

Primary OutcomePrimary Outcome

CV Death, MI, Stroke, CV Death, MI, Stroke, CHF HospCHF Hosp

1412 (16.461412 (16.46%)%)

1423 (16.661423 (16.66%)%)

1.011.01

(0.94-1.09)(0.94-1.09)

0.00380.0038

(Adjusted for SBP)(Adjusted for SBP) 1.021.02

(0.95-1.10)(0.95-1.10)

0.00550.0055

HOPE Primary OutcomeHOPE Primary Outcome

CV Death, MI, StrokeCV Death, MI, Stroke 1210 (14.111210 (14.11%)%)

1190 (13.931190 (13.93%)%)

0.99 0.99

(0.91-1.07)(0.91-1.07)

0.00090.0009

(Adjusted for SBP)(Adjusted for SBP) 0.990.99

(0.91-1.07)(0.91-1.07)

0.00120.0012

Yusuf, et al. N ENGL J MED.358;15:1547-1559

ONTARGET

Time to Primary OutcomeTime to Primary Outcome

Tel.&Ram.Tel.&Ram.

Tel.&Ram.Tel.&Ram.

RamiprilRamipril

NO. at RiskNO. at Risk

RamiprilRamiprilYears of Follow-upYears of Follow-up

Cu

mu

lati

ve H

azar

d R

ates

Cu

mu

lati

ve H

azar

d R

ates

85768576 82148214 78327832 74737473 7095709585028502 81348134 77407740 73777377 70237023

Yusuf, et al. N ENGL J MED.358;15:1547-1559

ONTARGET

Reasons for Permanently Reasons for Permanently Stopping Study MedicationsStopping Study Medications

RamRam

N=8576N=8576

Ram + TelRam + Tel

N=8502N=8502

Ram + Tel vs. RamRam + Tel vs. Ram

RR PRR P

HypotensionHypotension 149149 406406 2.752.75 <0.0001<0.0001

SyncopeSyncope 1515 2929 1.951.95 0.0320.032

CoughCough 360360 392392 1.101.10 0.18850.1885

DiarrheaDiarrhea 1212 3939 3.283.28 0.00010.0001

AngioedemaAngioedema 2525 1818 0.730.73 0.300.30

Renal ImpairmentRenal Impairment 6060 9494 1.581.58 0.00500.0050

Any DiscontinuationAny Discontinuation 20992099 24952495 1.201.20 <0.0001<0.0001

Yusuf, et al. N ENGL J MED.358;15:1547-1559

ONTARGET