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Cardiovascular morbidity and mortality in the Losartan Intervention For Endpoint reduction in hypertension study (LIFE): a randomised trial against atenolol.

Background: Blood pressure reduction achieved with beta-blockers and diuretics is the best recorded intervention to date for prevention of cardiovascular morbidity and death in patients with hypertension. Left ventricular hypertrophy (LVH) is a strong independent indicator of risk of cardiovascular...

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Publicado en:Lancet Vol. 359; no. 9311; pp. 995 - 1004
Autores principales: Dahlöf B, Devereux RB, Kjeldsen SE, Julius S, Beevers G, de Faire U, Fyhrquist F, Ibsen H, Kristiansson K, Lederballe-Pedersen O, Lindholm LH, Nieminen MS, Omvik P, Oparil S, Wedel H, Dahlöf, Björn, Devereux, Richard B, Kjeldsen, Sverre E, Julius, Stevo, Beevers, Gareth
Formato: clinical trial research tables/charts Journal Article
Publicado: Lancet 3/23/2002
Acceso en línea:Ver este registro en EBSCOhost
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      dt: 3/23/2002
      vid: 359
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      pub: Lancet
      place: Philadelphia, Pennsylvania
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        NLM11937178
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        10.1016/s0140-6736(02)08089-3
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        atl: Cardiovascular morbidity and mortality in the Losartan Intervention For Endpoint reduction in hypertension study (LIFE): a randomised trial against atenolol.
      aug:
        au:
          Dahlöf B
          Devereux RB
          Kjeldsen SE
          Julius S
          Beevers G
          de Faire U
          Fyhrquist F
          Ibsen H
          Kristiansson K
          Lederballe-Pedersen O
          Lindholm LH
          Nieminen MS
          Omvik P
          Oparil S
          Wedel H
          Dahlöf, Björn
          Devereux, Richard B
          Kjeldsen, Sverre E
          Julius, Stevo
          Beevers, Gareth
        affil: Sahlgrenska University Hospital/Ostra, Gothenburg, Swede
      sug:
        subj:
          Atenolol Therapeutic Use
          Cardiovascular Diseases Prevention and Control
          Hypertension Drug Therapy
          Hypertrophy, Left Ventricular Prevention and Control
          Losartan Therapeutic Use
          Aged
          Cardiovascular Diseases Mortality
          Confidence Intervals
          Cox Proportional Hazards Model
          Double-Blind Studies
          Kaplan-Meier Estimator
          Middle Age
          Relative Risk
          Survival Analysis
          Wilcoxon Rank Sum Test
          Funding Source
          Human
          Aged: 65+ years
          Middle Aged: 45-64 years
      ab: Background: Blood pressure reduction achieved with beta-blockers and diuretics is the best recorded intervention to date for prevention of cardiovascular morbidity and death in patients with hypertension. Left ventricular hypertrophy (LVH) is a strong independent indicator of risk of cardiovascular morbidity and death. We aimed to establish whether selective blocking of angiotensin II improves LVH beyond reducing blood pressure and, consequently, reduces cardiovascular morbidity and death.Methods: We did a double-masked, randomised, parallel-group trial in 9193 participants aged 55-80 years with essential hypertension (sitting blood pressure 160-200/95-115 mm Hg) and LVH ascertained by electrocardiography (ECG). We assigned participants once daily losartan-based or atenolol-based antihypertensive treatment for at least 4 years and until 1040 patients had a primary cardiovascular event (death, myocardial infarction, or stroke). We used Cox regression analysis to compare regimens.Findings: Blood pressure fell by 30.2/16.6 (SD 18.5/10.1) and 29.1/16.8 mm Hg (19.2/10.1) in the losartan and atenolol groups, respectively. The primary composite endpoint occurred in 508 losartan (23.8 per 1000 patient-years) and 588 atenolol patients (27.9 per 1000 patient-years; relative risk 0.87, 95% CI 0.77-0.98, p=0.021). 204 losartan and 234 atenolol patients died from cardiovascular disease (0.89, 0.73-1.07, p=0.206); 232 and 309, respectively, had fatal or non-fatal stroke (0.75, 0.63-0.89, p=0.001); and myocardial infarction (non-fatal and fatal) occurred in 198 and 188, respectively (1.07, 0.88-1.31, p=0.491). New-onset diabetes was less frequent with losartan. Interpretation Losartan prevents more cardiovascular morbidity and death than atenolol for a similar reduction in blood pressure and is better tolerated. Losartan seems to confer benefits beyond reduction in blood pressure.
      pubtype: Academic Journal
      doctype:
        clinical trial
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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