Losartan versus atenolol for hypertensive patients with LVH

Losartan appears to prevent slightly more cardiovascular morbidity than atenolol in patients with LVH

In a double-masked, randomized, parallel-group trial (LIFE) 9 193 patients aged 55 - 88 years with electrocardiographically ascertained LVH received either losartan ad 100 mg/d or atenolol 100 mg/d. Most patients also received hydrochlorothiazide. The primary composite end point (death, myocardial infarction, or stroke) occurred in 508 losartan (23.8 per 1000 patient years) and 588 atenolol patients (27.9 per 1 000 patient years, RR 0.87, 95% CI 0.77 to 0.98). The risk of cardiovascular death for losartan treated patients was 0.89, 95% CI 0.73 to 1.07) of fatal or non-fatal stroke 0.75, 95% CI 0.63 to 0.89), and of myocardial infarction 1.07, 95% CI 0.88 to 1.31).

Comment: The quality of evidence is downgraded by imprecise results (few outcome events).

Ədəbiyyat

1. 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, LIFE Study Group. Cardiovascular morbidity and mortality in the Losartan Intervention For Endpoint reduction in hypertension study (LIFE): a randomised trial against atenolol. Lancet 2002 Mar 23;359(9311):995-1003.