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Rates of the combined end point—death from cardiovascular causes, heart attack, stroke, or hospital admission for heart failure—were 16.5% (1412/8576) in participants who took ramipril and 16.7% (1423/8542) in those who took telmisartan. Both groups took their assigned drug for a median of 56 months. The drugs’ benefits were statistically indistinguishable, but telmisartan was associated with a lower risk of cough (1.1% v 4.2%, P<0.001), a lower risk of angio-oedema (0.1% v 0.3%, P=0.01), and a higher risk of hypotensive symptoms excluding syncope (2.6% v 1.7%, P<0.001).
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http://content.nejm.org/cgi/content/abstract/358/15/1547