老年高血压降压指南.pptVIP

* * The ONTARGET Trial Programme consists of the main trial, ONTARGET, the parallel trial, TRANSCEND (with ACE inhibitor intolerant patients), and 7 substudies. The ONTARGET Trial Programme has been designed to evaluate the role of the angiotensin receptor blocker (ARB) Telmisartan in cardiovascular protection. The principal investigator of this global trial is Salim Yusuf D. Phil, FRCPC, Prof. of Medicine, Director, Division of Cardiology, Director, Population Health Institute, McMaster University, Hamilton, Canada The ONTARGET Trial Programme is mainly sponsored by Boehringer Ingelheim and co-sponsored by GlaxoSmithKline. * * After screening, patients are included either in the ONTARGET - or the TRANSCEND trial. ONTARGET patients are titrated to telmisartan 80 mg/day, or ramipril 10 mg/day, or a combination of telmisartan 80 mg/day and ramipril 10 mg/day (receiving matching placebos in the monotherapy groups). In the TRANSCEND trial, telmisartan 80 mg/day is tested against placebo. Both trials have a follow-up period of 5.5 years. * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * 随机到活性药物治疗组的患者接受雅施达4mg/日的治疗。由经治医生决定是否加用纳催离以达到理想降压目标。 * * * * 2021/3/23 * ONTARGET: Change in BP (mmHg) Ramipril Telmisartan Combination Systolic -6.0 -6.9 -8.4 Diastolic -4.6 -5.2 -6.0 2021/3/23 * Time to Primary Outcome ONTARGET 2021/3/23 * ONTARGET: Primary Outcome  HOPE Primary Outcome Ram Tel Tel vs Ram N (%) N (%) RR (95% CI) P (non-inf) N 8576 8542 Primary Outcome CV Death, MI, Stroke, CHF Hosp 1412 (16.46%) 1423 (16.66%) 1.01 (0.94-1.09) 0.0038 (Adjusted for SBP) 1.02 (0.95-1.10) 0.0055 HOPE Primary Outcome CV Death, MI, Stroke 1210 (14.11%) 1190 (13.93%) 0.99 (0.91-1.07) 0.0009 (Adjusted for SBP) 0.99 (0.91-1.07) 0.0012 2021/3/23 * 非劣势比较(Non-Inferiority Comparison) Tel vs. Ram ONTARGET 2021/3/23 * ONTARGET Non-Inferiority Comparison ONTARGET 2021/3/23 * Indirect Comparison of Telmisartan to Placebo Percentage of Ramipril’s Effects That is Preserved HO