(Hypertension. 1998;32:989-997.)
© 1998 American Heart Association, Inc.
Scientific Contributions |
From Sahlgrenska University Hospital/Östra, Göteborg, Sweden (B.D.); New York HospitalCornell Medical Center, New York, NY (R.B.D.); University of Michigan Medical Center, Ann Arbor, Michigan (S.J.); Ullevaal University Hospital, Oslo, Norway (S.E.K.); City Hospital, Birmingham, UK (G.B.); Karolinska University Hospital, Stockholm, Sweden (U. de F.); Helsinki University Central Hospital, Helsinki, Finland (F.F., M.S.N.); Sahlgrenska University Hospital, Göteborg, Sweden (T.H.); Glostrup University Hospital, Glostrup, Denmark (H.I.); MRL Scandinavia, Stockholm, Sweden (K.K.); Viborg Hospital, Viborg, Denmark (O.L.-P.); Umeå University, Umeå, Sweden (L.H.L.); Haukeland University Hospital, Bergen, Norway (P.O.); University of Alabama Medical Center, Birmingham, Alabama (S.O.); The Nordic School of Public Health, Göteborg, Sweden (H.W.).
Correspondence to Sverre E. Kjeldsen, MD, PhD, Division of Cardiology, Department of Internal Medicine, Ullevaal Hospital, N-0407 Oslo, Norway. E-mail sverrekj{at}ulrik.uio.no
AbstractLosartan was
the first available orally administered selective
antagonist of the angiotensin II type 1
receptor developed for the treatment of hypertension. The
Losartan Intervention For Endpoint (LIFE) Reduction in
Hypertension Study is a double-blind, prospective, parallel group study
designed to compare the effects of losartan with those of the
ß-blocker atenolol on the reduction of cardiovascular
morbidity and mortality. Patients with essential hypertension, aged
between 55 and 80 years, and ECG-documented left
ventricular hypertrophy (LVH) were included.
Altogether, 9223 patients in Scandinavia, the United Kingdom, and the
United States were randomized from June 1995 through April 1997, and
9194 remain after exclusion of a study center at which irregularities
were discovered. This population of hypertensives (mean
systolic/diastolic blood pressure, 174.4/97.8
mm Hg) with LVH comprises women (54.1%) and men, mostly retired from
active work (mean age, 66.9 years), with a high prevalence of
overweight (mean body mass index, 28.0 kg/m2), diabetes
mellitus (12.3%), lipid disorders (18.0%), and symptoms or signs of
coronary heart disease (15.1%). There were fewer current
smokers (<17%) than in the general population, and
7% were
nonwhite. Almost 30% of participants had been untreated for at least 6
months when screened for the study. Only 1557 persons who entered the
placebo run-in period of 14 days were excluded, predominantly because
of sitting blood pressures above or below the predetermined range of
160-200/95-115 mm Hg and ECG-LVH criteria not met. By application
of simple 12-lead ECG criteria for LVH (Cornell voltage QRS duration
product formula plus Sokolow-Lyon voltage read by a core
laboratory), hypertensive patients with LVH with an average 5-year
coronary heart disease risk of 22.3% according to the
Framingham score were identified. This population is now being treated
(goal, <140/90 mm Hg) in adherence with the protocol for at
least 4 years after final enrollment (ie, through April 2001) and until
at least 1040 patients suffer myocardial infarction, stroke, or
cardiovascular death.
Key Words: atenolol antihypertensive agents cardiovascular diseases hypertrophy, left ventricular losartan randomized controlled trials
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