[Treatment of hypertension in patients with left ventricular hypertrophy].
BACKGROUND
The LIFE study (Losartan Intervention For Endpoint reduction in hypertension) is a randomized, double-blind comparison of losartan and atenolol-based treatment. The study hypothesis was that losartan would reduce cardiovascular morbidity and mortality more than traditional antihypertensive treatment with atenolol.


METHODS
The study included 9193 patients in seven countries.


RESULTS
By the end of the study, the mean dose was losartan 82 mg and atenonol 79 mg, whereas 94% of patients in both groups received additional hydrochlorothiazide. Blood pressure was reduced 30/17 mmHg by losartan and 29/17 mm Hg by atenolol. Despite the same reduction in blood pressure, the primary combined endpoint (cardiovascular mortality, non-fatal stroke and myocardial infarction) was reduced by 13.0% (p = 0.021) in the losartan group. Non-fatal and fatal strokes were reduced by 24.9% (p = 0.001). In two pre-specified subgroup analyses, cardiovascular mortality was reduced by 46% (p = 0.01) in patients with isolated systolic hypertension (n = 1326), and total mortality was reduced by 39% (p = 0.002) in patients with diabetes (n = 1159).


CONCLUSIONS
Losartan prevented more cardiovascular complications than atenolol for the same reduction in blood pressure and have positive additional effects beyond blood pressure control in patients with hypertension and left ventricular hypertrophy.
Omvik
Per
P
LIFE-studiegruppen. per.omvik@med.uib.no
Bratland
Bjørn
B
Gerhardsen
Gerhard
G
Gisholt
Kjell
K
Risanger
Terje
T
Smedsrud
Tore
T
Kjeldsen
Sverre E
SE
D000368:Aged; D000959:Antihypertensive Agents / Q000008:administration & dosage*; D001262:Atenolol / Q000008:administration & dosage*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000188:drug therapy* / Q000401:mortality; D017379:Hypertrophy, Left Ventricular / Q000150:complications*; D019808:Losartan / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged
D000959:Antihypertensive Agents; D001262:Atenolol; D019808:Losartan