Effect of losartan on sudden cardiac death in people with diabetes: data from the LIFE study.
In the Losartan Intervention For Endpoint reduction in hypertension (LIFE) study, a major reduction of all-cause mortality--especially cardiovascular mortality--in patients with diabetes with left ventricular hypertrophy was reported for treatment with losartan. We postulated post hoc that losartan might have a better effect on sudden cardiac death than atenolol, and we aimed to test this hypothesis. 44 patients with diabetes died of sudden cardiac death; significantly fewer deaths arose in the losartan group (14) than in the atenolol group (30; p=0.027). In the losartan group, five (6%) of 86 patients with diabetes and atrial fibrillation during the trial died of sudden cardiac death compared with nine (2%) of 500 in those without atrial fibrillation. The respective figures for the atenolol group were 14 (13%) of 105 and 16 (3%) of 504. Our results suggest losartan affords better protection against cardiac death from arrhythmias for patients with diabetes mellitus than does atenolol. Importantly, our analyses were exploratory and require confirmation.
Lindholm
Lars H
LH
Department of Public Health and Clinical Medicine, Umeå University Hospital, SE 901 85, Umeå, Sweden. larsh.lindholm@fammed.umu.se
Dahlöf
Björn
B
Edelman
Jonathan M
JM
Ibsen
Hans
H
Borch-Johnsen
Knut
K
Olsen
Michael Hecht
MH
Snapinn
Steven
S
Wachtell
Kristian
K
D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001145:Arrhythmias, Cardiac / Q000453:epidemiology / Q000401:mortality*; D001262:Atenolol / Q000627:therapeutic use; D001281:Atrial Fibrillation / Q000453:epidemiology / Q000401:mortality; D015897:Comorbidity; D016757:Death, Sudden, Cardiac / Q000453:epidemiology / Q000517:prevention & control*; D048909:Diabetes Complications; D003920:Diabetes Mellitus / Q000453:epidemiology / Q000401:mortality; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000453:epidemiology / Q000401:mortality; D017379:Hypertrophy, Left Ventricular / Q000453:epidemiology / Q000401:mortality; D019808:Losartan / Q000627:therapeutic use*; D008297:Male
D000959:Antihypertensive Agents; D001262:Atenolol; D019808:Losartan