The ONTARGET trial compared the angiotensin receptor blocker (ARB) telmisartan to the angiotensin converting enzyme (ACE) inhibitor ramipril and their combination in 25,620 patients with cardiovascular disease or diabetes. The trial found that telmisartan was noninferior to ramipril for the primary outcome of cardiovascular death, heart attack, stroke or hospitalization for heart failure. The combination of telmisartan and ramipril showed no additional benefit compared to ramipril alone and was associated with more side effects such as renal impairment.