Telmisartan, ramipril, or both in patients at high risk of vascular events.

摘要: To the Editor: The investigators of Ongoing Telmisartan Alone and in Combination with Ramipril Global Endpoint Trial (ONTARGET) (April 10 issue)1 report that telmisartan is equivalent to ramipril patients vascular disease or high-risk diabetes. However, primary composite end point death from cardiovascular causes, myocardial infarction, stroke, hospitalization for heart failure was not lower combination-therapy group than receiving alone, even though blood-pressure levels were 2.4/1.4 mm Hg those throughout study period. Still more disturbing a trend toward deaths noncardiovascular causes (deaths 620 vs. 603 598, respectively; 445 411 391, respectively). Given number hyperkalemia much higher (480 283 287, respectively), as hypotensive symptoms (406 149 229, we wonder whether specific cause (i.e., sudden arrhythmia) can be identified group. Data such an analysis should provided.