The ONTARGET study is quite rightly being heralded as one of the most important cardiovascular studies for nearly ten years. It helps us understand how people in the UK at the highest risk of cardiovascular disease can best be protected from the devastating effects of heart attacks and strokes." Bryan Williams, Professor of Medicine at the University of Leicester and an ONTARGET investigator.

Results of the ONTARGET study, presented at the American College of Cardiology's 57th Annual Scientific Sessions, and published in the New England Journal of Medicine (NEJM), show that telmisartan (Micardis(R) - an angiotensin receptor blocker or ARB) provides highly effective protection against cardiovascular events such as heart attacks and strokes. Cardiovascular disease remains the UK's biggest killer and death rates in the UK are still amongst the highest in Western Europe.(1, 2) Telmisartan is currently licensed in the UK for the treatment of essential hypertension.

"The results of this landmark study could change the way we currently manage those at risk of cardiovascular disease, which accounts for approximately one in every three deaths in the UK and costs the economy as much as GBP26 billion a year," commented Professor Stephen Ball, British Heart Foundation Professor of Cardiology, University of Leeds. "Although there have been steady improvements since the National Service Framework (NSF) for coronary heart disease was introduced, we simply can't afford to take our eyes off the ball with the vast numbers of those living with the daily risk of heart attack and stroke"

In ONTARGET, a study conducted among 25,600 people at high-risk risk of a cardiovascular event, such as heart attack or stroke, 83.3% of those receiving telmisartan remained free from an event after 5 years. This was equivalent to the 83.5% who remained event-free when treated with the ACE inhibitor ramipril, the current gold standard preventative treatment. However, those patients taking telmisartan experienced significantly fewer side effects, an important consideration when managing long-term conditions such as cardiovascular disease.(3)

"The results of ONTARGET suggest that, with telmisartan, we may now have a treatment option for high-risk patients that is better tolerated and that patients may prefer to take, meaning they are more likely to stay on their treatment in the long term, benefiting from the cardiovascular protection it provides. This clarifies our treatment options and could help prevent thousands of deaths from cardiovascular events in the UK each year," commented Bryan Williams, Professor of Medicine at the University of Leicester and an ONTARGET investigator.

The study also investigated whether the combination of telmisartan and ramipril provided a greater reduction in cardiovascular events when compared to the effect of ramipril. The results of ONTARGET showed however that there was no additional cumulative benefit of administering telmisartan and ramipril together.(3)

Michael, 50, a lecturer in nursing from Manchester, was diagnosed with high blood pressure at the age of 47. "Since the death of my father from a heart attack when he was just 46, I've been careful to keep healthy and active by running half marathons, cycling to work, playing football every week and maintaining a healthy diet. However, four years ago I received the news I was dreading, that I too suffered from high blood pressure. I knew how important it was to get to grips with it to ensure I didn't suffer a heart attack like my Dad, and with help from my family, preventative drug treatment and a healthy lifestyle, I've been able to keep my blood pressure under control."

ONTARGET (the ONgoing Telmisartan Alone and in combination with Ramipril Global Endpoint Trial), is the largest cardiovascular trial ever undertaken with an ARB. Conducted over a period of five years, it involved more than 25,600 people across 40 countries with a wide range of cardiovascular risk factors and with normal or controlled blood pressure.(3)

*Telmisartan is currently licensed in the UK for the treatment of essential hypertension For further information please visit boehringer-ingelheim.

About ONTARGET (3)

- ONTARGET is a randomised, double blind clinical trial, which evaluated over 25,600 high-risk cardiovascular patients with normal or controlled blood pressure.

- An outcomes-led study, ONTARGET is the largest cardiovascular trial undertaken with an ARB and included the broadest population ever included in this type: high-risk cardiovascular patients with a history of coronary heart disease, stroke, transient ischaemic attack, peripheral vascular disease or diabetes with target organ damage.

- ONTARGET is an academic-led study managed by the trials centre at McMaster University, Hamilton, Canada and took place in over 700 centres across 40 countries.

- A parallel trial, TRANSCEND (Telmisartan Randomised Assessment Study in ACE-intolerant subjects with cardiovascular disease) is ongoing, and is the first trial to test the cardiovascular protective effect of an ARB (telmisartan) versus placebo, on top of standard therapy (including anti-hypertensives, anti- platelets, statins), in individuals who cannot tolerate an ACE inhibitor.

- ONTARGET forms part of the Landmark study programme, a series of large-scale, randomised, controlled clinical trials for thousands of patients recruited from a great number of sites around the world. These Landmark studies include the ONTARGET/TRANSCEND, PRoFESS, UPLIFT and RE-VOLUTION trial programmes.

About telmisartan (Micardis(R))

Telmisartan, discovered and developed by Boehringer Ingelheim, is a member of the Angiotensin II Receptor Blocker (ARB) class. It is being investigated in the most ambitious and far-reaching research programme conducted with an ARB. In the ongoing clinical trial programmes ONTARGET, PROTECTION and PRoFESS, over 58,000 patients have been enrolled to investigate the cardiovascular protective effects of telmisartan. Telmisartan is indicated for the treatment of essential hypertension.

About CVD

- CVD remains the UK's biggest killer, causing 1 in 3 deaths. Despite recent improvements, death rates in the UK are still amongst the highest in Western Europe.(1, 2)

- CVD is predicted to be the largest cause of disability worldwide by 2020.(4)

- Overall CVD is estimated to cost the UK economy just under GBP26 billion a year.(5)

About Boehringer Ingelheim

The Boehringer Ingelheim group is one of the world's 20 leading pharmaceutical companies. Headquartered in Ingelheim, Germany, it operates globally with 137 affiliates in 47 countries and 38,400 employees. Since it was founded in 1885, the family-owned company has been committed to researching, developing, manufacturing and marketing novel products of high therapeutic value for human and veterinary medicine.

In 2006, Boehringer Ingelheim posted net sales of 10.6 billion euro while spending one fifth of net sales in its largest business segment Prescription Medicines on research and development. boehringer-ingelheim


1. British Heart Foundation. British Heart Foundation Statistics Website: Numbers dying from CVD and CHD (last accessed 30 March 2008) heartstats/datapage.asp?id=713

2. British Heart Foundation. British Heart Foundation Statistics Website: Mortality (last accessed 30 March 2008) heartstats/datapage.asp?id=71

3. Yusuf S et al. Telmisartan, Ramipril, or Both in Patients at High Risk for Vascular Events. N Eng J Med 2008; 358:1547-59

4. World Health Organisation. Fact Sheet 317: Cardiovascular Diseases (last accessed 30 March 2008) See here.

5. British Heart Foundation. British Heart Foundation Statistics Website: Numbers dying from CVD and CHD (last accessed 30 March 2008) See here.


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