Condition category
Circulatory System
Date applied
Date assigned
Last edited
Prospectively registered
Overall trial status
Recruitment status
No longer recruiting

Plain English Summary

Not provided at time of registration

Trial website

Contact information



Primary contact

Dr Salim Yusuf


Contact details

Population Health Research Institute
McMaster University
Hamilton General Hospital
McMaster Clinic
237 Barton St E
Ontario L8L 2X2
+1 (0)905 527 4322 ext 44515

Additional identifiers

EudraCT number number


Protocol/serial number


Study information

Scientific title

ONgoing Telmisartan Alone or in combination with Ramipril Global Endpoint Trial



Study hypothesis

To determine if:
1. Telmisartan (Micardis) 80 mg daily and Ramipril (Delix protect) 10 mg daily combination therapy is more effective in reducing the composite endpoint of Cardiovascular (CV) death, Myocardial Infarction (MI), stroke or hospitalisation for Congestive Heart Failure (CHF) compared with Ramipril 10 mg alone; and
2. Telmisartan 80 mg daily is at least as effective as (i.e. not less effective than) Ramipril 10 mg daily

A parallel trial "Telmisartan Randomised Assessment Study in Ace Intolerant Subjects with Cardiovascular Disease (TRANSCEND)" is registered with ISRCTN75807641.

Ethics approval

Not provided at time of registration

Study design

Prevention randomised double-blind active-controlled parallel assignment

Primary study design


Secondary study design

Randomised parallel trial

Trial setting


Trial type


Patient information sheet

Not available in web format, please use the contact details below to request a patient information sheet


Congestive heart failure


Ramipril (an ACE inhibitor), telmisartan (an angiotensin II blocker), their combination, or matched placebos.

Intervention type



Not Applicable

Drug names

Telmisartan, ramipril

Primary outcome measures

1. Cardiovascular death
2. Non-fatal myocardial infarction
3. Non-fatal stroke
4. Hospitalisation for congestive heart failure

Secondary outcome measures

1. Newly diagnosed congestive heart failure
2. Cardiovascular revascularisation procedures
3. Newly diagnosed diabetes
4. Cognitive decline (adjudication will be done by a special committee)
5. New onset of atrial fibrillation
6. Nephropathy

Overall trial start date


Overall trial end date


Reason abandoned


Participant inclusion criteria

1. Adults greater than or equal to 55 years
2. With a history of symptomatic coronary artery disease, cerebrovascular disease, peripheral vascular disease, or diabetes mellitus
3. Coronary Artery Disease: previous MI (greater than 2 days prior to informed consent), or stable or previous unstable angina (greater than 30 days prior to informed consent) with documented multivessel coronary artery disease or a positive stress test, or multivessel Percutaneous Transluminal Coronary Angioplasty (PTCA) (greater than 30 days prior to informed consent), or previous multivessel Coronary Artery Bypass Graft (CABG) without angina (if surgery performed greater than 4 years prior to informed consent) or with recurrent angina after surgery
4. No definite and specific indication or contraindication for any of the study treatments
5. Written informed consent

Other High Risk:
6. Peripheral Arterial Disease: previous limb bypass surgery or angioplasty or amputation, intermittent claudication on history with ankle/arm Blood Pressure (BP) ratio less than 0.8 on at least one side, or significant stenosis by angiography or non-invasive testing
7. Previous stroke
8. Transient Ischaemic Attach (TIA) greater than 7 days and less than 1 year prior to informed consent
9. Diabetes Mellitus (types I or II): with evidence of end-organ damage (retinopathy, Left Ventricular Hypertrophy [LVH], micro- or macro-albuminuria), or any evidence of previous cardiac or vascular disease

Participant type


Age group




Target number of participants


Participant exclusion criteria

Does not match inclusion criteria

Recruitment start date


Recruitment end date



Countries of recruitment

Argentina, Australia, Austria, Belgium, Brazil, Canada, Czech Republic, Denmark, Finland, France, Germany, Greece, Hong Kong, Hungary, Ireland, Italy, Korea, South, Malaysia, Mexico, Netherlands, New Zealand, Norway, Philippines, Poland, Portugal, Puerto Rico, Russian Federation, Singapore, Slovakia, South Africa, Spain, Sweden, Switzerland, Taiwan, Thailand, Turkey, Ukraine, United Arab Emirates, United Kingdom, United States of America

Trial participating centre

Hamilton General Hospital
Ontario L8L 2X2

Sponsor information


Boehringer Ingelheim (Canada) Ltd

Sponsor details

Research and Development
2100 Cunard Street
Laval (Québec)
H7S 2G5
+1 450 682 4640

Sponsor type




Funder type


Funder name

Boehringer Ingelheim (Canada) Ltd

Alternative name(s)

Funding Body Type

Funding Body Subtype


Results and Publications

Publication and dissemination plan

Not provided at time of registration

Intention to publish date

Participant level data

Not provided at time of registration

Results - basic reporting


Publication summary

2004 protocol in:
2005 baseline data in:
2007 results in:
2008 results in:
2008 results in:
2009 results in:
2010 results in:
2013 results in:

Publication citations

  1. Results

    Verdecchia P, Sleight P, Mancia G, Fagard R, Trimarco B, Schmieder RE, Kim JH, Jennings G, Jansky P, Chen JH, Liu L, Gao P, Probstfield J, Teo K, Yusuf S, , Effects of telmisartan, ramipril, and their combination on left ventricular hypertrophy in individuals at high vascular risk in the Ongoing Telmisartan Alone and in Combination With Ramipril Global End Point Trial and the Telmisartan Randomized Assessment Study in ACE Intolerant Subjects With Cardiovascular Disease., Circulation, 2009, 120, 14, 1380-1389, doi: 10.1161/CIRCULATIONAHA.109.865774.

  2. Results

    Böhm M, Baumhäkel M, Teo K, Sleight P, Probstfield J, Gao P, Mann JF, Diaz R, Dagenais GR, Jennings GL, Liu L, Jansky P, Yusuf S, , Erectile dysfunction predicts cardiovascular events in high-risk patients receiving telmisartan, ramipril, or both: The ONgoing Telmisartan Alone and in combination with Ramipril Global Endpoint Trial/Telmisartan Randomized AssessmeNt Study in ACE iNtolerant subjects with cardiovascular Disease (ONTARGET/TRANSCEND) Trials., Circulation, 2010, 121, 12, 1439-1446, doi: 10.1161/CIRCULATIONAHA.109.864199.

  3. Results

    Heerspink HJ, Gao P, Zeeuw Dd, Clase C, Dagenais GR, Sleight P, Lonn E, Teo KT, Yusuf S, Mann JF, The effect of ramipril and telmisartan on serum potassium and its association with cardiovascular and renal events: results from the ONTARGET trial., Eur J Prev Cardiol, 2014, 21, 3, 299-309, doi: 10.1177/2047487313510678.

  4. Teo K, Yusuf S, Sleight P, Anderson C, Mookadam F, Ramos B, Hilbrich L, Pogue J, Schumacher H, , Rationale, design, and baseline characteristics of 2 large, simple, randomized trials evaluating telmisartan, ramipril, and their combination in high-risk patients: the Ongoing Telmisartan Alone and in Combination with Ramipril Global Endpoint Trial/Telmisartan Randomized Assessment Study in ACE Intolerant Subjects with Cardiovascular Disease (ONTARGET/TRANSCEND) trials., Am. Heart J., 2004, 148, 1, 52-61, doi: 10.1016/j.ahj.2004.03.020.

  5. Sleight P, The ONTARGET/TRANSCEND Trial Programme: baseline data., Acta Diabetol, 2005, 42 Suppl 1, S50-6, doi: 10.1007/s00592-005-0181-3.

  6. Held C, Gerstein HC, Yusuf S, Zhao F, Hilbrich L, Anderson C, Sleight P, Teo K, , Glucose levels predict hospitalization for congestive heart failure in patients at high cardiovascular risk., Circulation, 2007, 115, 11, 1371-1375, doi: 10.1161/CIRCULATIONAHA.106.661405.

  7. , Yusuf S, Teo KK, Pogue J, Dyal L, Copland I, Schumacher H, Dagenais G, Sleight P, Anderson C, Telmisartan, ramipril, or both in patients at high risk for vascular events., N. Engl. J. Med., 2008, 358, 15, 1547-1559, doi: 10.1056/NEJMoa0801317.

  8. Mann JF, Schmieder RE, McQueen M, Dyal L, Schumacher H, Pogue J, Wang X, Maggioni A, Budaj A, Chaithiraphan S, Dickstein K, Keltai M, Metsärinne K, Oto A, Parkhomenko A, Piegas LS, Svendsen TL, Teo KK, Yusuf S, , Renal outcomes with telmisartan, ramipril, or both, in people at high vascular risk (the ONTARGET study): a multicentre, randomised, double-blind, controlled trial., Lancet, 2008, 372, 9638, 547-553, doi: 10.1016/S0140-6736(08)61236-2.

Additional files

Editorial Notes

21/03/2016: added link to results - basic reporting.