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Effects of losartan on cardiovascular morbidity and mortality in patients with isolated systolic hypertension and left ventricular hypertrophy: a Losartan Intervention for Endpoint Reduction (LIFE) substudy.
| Content Provider | Semantic Scholar |
|---|---|
| Author | Kjeldsen, Sverre Erik Dahlöf, Björn Devereux, Richard Blyton Julius, Stevo Aurup, Peter Edelman, Jonathan Beevers, Gareth D. Faire, Ulf H. De Fyhrquist, Frej Y. Ibsen, Hans Henning Windeløv Kristianson, Krister J. Lederballe-Pedersen, Ole Lindholm, Lars Nieminen, Markku S. Omvik, Per Oparil, Suzanne Snapinn, Steven Wedel, Hans |
| Copyright Year | 2002 |
| Abstract | CONTEXT Drug intervention in placebo-controlled trials has been beneficial in isolated systolic hypertension. OBJECTIVE To test the hypothesis that losartan improves outcome better than atenolol in patients with isolated systolic hypertension and electrocardiographically documented left ventricular hypertrophy (ECG-LVH). DESIGN Double-blind, randomized, parallel-group study conducted in 1995-2001. SETTING AND PARTICIPANTS A total of 1326 men and women aged 55 through 80 years (mean, 70 years) with systolic blood pressure of 160 to 200 mm Hg and diastolic blood pressure of less than 90 mm Hg (mean, 174/83 mm Hg) and ECG-LVH, recruited from 945 outpatient settings in the Nordic countries, the United Kingdom, and the United States. INTERVENTIONS Patients were randomly assigned to receive once-daily losartan (n = 660) or atenolol (n = 666) with hydrochlorothiazide as the second agent in both arms, for a mean of 4.7 years. MAIN OUTCOME MEASURE Composite end point of cardiovascular death, stroke, or myocardial infarction. RESULTS Blood pressure was reduced by 28/9 and 28/9 mm Hg in the losartan and atenolol arms. The main outcome was reduced by 25% with losartan compared with atenolol, 25.1 vs 35.4 events per 1000 patient-years (relative risk [RR], 0.75; 95% confidence interval [CI], 0.56-1.01; P =.06, adjusted for risk and degree of ECG-LVH; unadjusted RR, 0.71; 95% CI, 0.53-0.95; P =.02). Patients receiving losartan had reductions in the following without a difference in the incidence of myocardial infarction: cardiovascular mortality (8.7 vs 16.9 events per 1000 patient-years; RR, 0.54; 95% CI, 0.34-0.87; P =.01), nonfatal and fatal stroke (10.6 vs 18.9 events per 1000 patient-years; RR, 0.60; 95% CI, 0.38-0.92; P =.02), new-onset diabetes (12.6 vs 20.1 events per 1000 patient-years; RR, 0.62; 95% CI, 0.40-0.97; P =.04), and total mortality (21.2 vs 30.2 events per 1000 patient-years; RR, 0.72; 95% CI, 0.53-1.00; P =.046). Losartan decreased ECG-LVH more than atenolol (P<.001) and was better tolerated. CONCLUSION These data suggest that losartan is superior to atenolol for treatment of patients with isolated systolic hypertension and ECG-LVH. |
| Starting Page | 1 |
| Ending Page | 5 |
| Page Count | 5 |
| File Format | PDF HTM / HTML |
| Alternate Webpage(s) | http://jama.jamanetwork.com/pdfaccess.ashx?url=/data/journals/jama/4849/joc20469.pdf |
| Alternate Webpage(s) | https://jama.jamanetwork.com/journals/JAMA/articlepdf/195319/joc20469.pdf |
| PubMed reference number | 12243636v1 |
| Volume Number | 288 |
| Issue Number | 12 |
| Journal | JAMA |
| Language | English |
| Access Restriction | Open |
| Subject Keyword | Alveolar rhabdomyosarcoma Atenolol Blood Pressure Cardiovascular Diseases Cerebrovascular accident Confidence Intervals Diabetes Mellitus Diastole Document completion status - Documented Hydrochlorothiazide Hypertension, systolic Hypertensive disease Left Ventricular Hypertrophy Losartan Mercury Morbidity - disease rate Myocardial Infarction One Thousand Patients PersonNameUse - assigned Pulmonary Hypertension |
| Content Type | Text |
| Resource Type | Article |
