A clinical trial which enrolled 25,000 patients age 25 or older with known atherosclerotic vascular disease or with diabetes and end-organ damage and randomised them to receive either the ARB telmisartan, ACE inhibitor ramipril or both.

Conclusion Patients receiving both agents had higher rates of death and renal disease than did the single therapy arms. 

Abbreviation for Ongoing Telmisartan Alone and in Combination with Ramipril Global Endpoint 

References Cleveland Clinic J of Med 2013; 80:209-217

Lancet 2008; 372:547-553. 

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