Study centers in 40 countries involved in heart pr

A total of 793 study centers in 40 countries have been recruited to enroll 28,400 patients over two years for the Ongoing Telmisartan Alone and in combination with Ramipril Global Endpoint Trial (ONTARGET) cardiovascular protection trial.

Boehringer Ingelheim, one of the world’s leading pharmaceutical companies, announced this at the European Society of Cardiology Congress in Stockholm, Sweden.

ONTARGET is one of the largest, most ambitious clinical studies to investigate the role of an angiotensis II receptor blocker (ARB) and an angiotensin converting enzyme (ACE) inhibitor alone or in combination to prevent stroke, myocardial infarction, cardiovascular death and hospitalization for congestive heart failure.

Both angiotensin II receptor blocker and angiotensis converting enzyme inhibitor are proven effective blood pressure lowering agents, said Prof. Craig Anderson, one of the study chairmen for the worldwide ONTARGET study program.

He said each has neuro-hormonal and other vascular protective effects by inhibiting the Renin-Angiortension System (RAS). More complete suppression of the RAS through combination therapy might lead to better outcomes in patients at high risk of cardiovascular disease, including stroke and dementia.

Since cardiovascular diseases are the most common causes of death in industrialized countries, many patients are looking for preventive treatment options.

Anderson said: "Dementia, stroke and myocardial infarction have their greatest impact on aging population as the incidence of each rises steeply with age. Individuals with a history of hypertension, diabetes, high cholesterol, smoking and previous vascular disease, have a very high risk of future cardiovascular disease. The evidence indicates that these vascular factors also play a role or even trigger the onset of age-related memory decline and dementia."

As another part of the ONTARGET trial program, Boehringer Ingelheim has also started the Telmisartan Randomized Assessment Study in ace intolerant subjects with cardiovascular Disease (TRANSCEND) trial. The parallel trial is the largest cardiovascular protection trial ever conducted in patients intolerant to ACE inhibitors. Patients were reported discontinuing the use of ACE inhibitors because of their specific side-effects, such as dry cough. The ONTARGET study centers will simultaneously take part in the parallel TRANSCEND trial with about 5,000 patients enrolled worldwide.

Prof. Peter Sleight, co-chairman of the ONTARGET study, said: "With ONTARGET and TRANSCEND, we are very much looking forward to fully understand the potential of angiotensin II receptor antagonists so that physicians will be able to offer an effective and tolerable treatment regimen to prevent their patients from life-threatening events such as myocardial infarction, stroke and devastating dementia."

Angiotensin II, a naturally occurring hormone, causes constriction of blood vessels and increases blood pressure. Both ARB and ACE inhibitor lower blood pressure by acting on angiotensin II. ARBs block the receptor sites found in many tissues for angiotensin II, one of the body’s most powerful vasoconstrictors. As a result, vasoconstriction is inhibited and blood flow is facilitated, thus reducing blood pressure. ACE inhibitors widen blood vessels and block the production of angiotensin II, thus lowering blood pressure.