Ambulatory blood pressure values in the ongoing telmisartan alone and in combination with ramipril global endpoint trial (ONTARGET)

Giuseppe Mancia, Gianfranco Parati, Grzegorz Bilo, Peggy Gao, Robert Fagard, Josep Redon, Istvan Czuriga, Martin Polák, Josè M. Ribeiro, Ramiro Sanchez, Bruno Trimarco, Paolo Verdecchia, Walter Van Mieghem, Koon Teo, Peter Sleight, Salim Yusuf

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Abstract

In the Ongoing Telmisartan Alone and in Combination with Ramipril Global Endpoint Trial, telmisartan (T; 80 mg daily) and ramipril (R; 10 mg daily) caused similar clinic blood pressure (BP) reductions, with a similar incidence of cardiovascular and renal events. The R+T combination lowered clinic BP somewhat more with no further cardiovascular or renal protection. The aim of this substudy was to see whether these clinic BP changes reflected the changes of 24-hour BP, a BP with a better prognostic value. In 422 patients in whom 24-hour BP monitoring was performed either before or after 6 to 24 months of treatment, demographic and clinical characteristics were similar in the 3 treated groups. Twenty-four-hour systolic BP was similarly reduced by R (-2.0 mm Hg) and T (-2.1 mm Hg), whereas the reduction was more than twice as large in the T+R group (-5.3 mm Hg), which showed a lower on-treatment 24-hour BP also in additional patients (n=408) in whom ambulatory BP was performed only on-treatment. Twenty-four-hour systolic BP was 14 mm Hg lower than clinic systolic BP at baseline, whereas during treatment the 2 values became progressively closer as clinic systolic BP was more tightly controlled and superimposable when clinic systolic BP was <120 mm Hg. Similar results were obtained for diastolic BP. These findings provide evidence on the relationship of clinic and ambulatory BP target drug treatment. They also show that in the Ongoing Telmisartan Alone and in Combination with Ramipril Global Endpoint Trial, failure of the R+T combination to enhance cardiovascular and renal protection was not because of inability to more effectively control daily life BP.

Original languageEnglish
Pages (from-to)1400-1406
Number of pages7
JournalHypertension
Volume60
Issue number6
DOIs
Publication statusPublished - Dec 1 2012

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Keywords

  • ambulatory blood pressure
  • angiotensin receptor blockers
  • angiotensin-converting enzyme inhibitors
  • antihypertensive treatment
  • high cardiovascular risk

ASJC Scopus subject areas

  • Internal Medicine

Cite this

Mancia, G., Parati, G., Bilo, G., Gao, P., Fagard, R., Redon, J., Czuriga, I., Polák, M., Ribeiro, J. M., Sanchez, R., Trimarco, B., Verdecchia, P., Van Mieghem, W., Teo, K., Sleight, P., & Yusuf, S. (2012). Ambulatory blood pressure values in the ongoing telmisartan alone and in combination with ramipril global endpoint trial (ONTARGET). Hypertension, 60(6), 1400-1406. https://doi.org/10.1161/HYPERTENSIONAHA.112.199562