Overall Results and Diabetic Patient Subset
Overall Study Question
These investigators examined the long term (4.8 years) benefits of treating hypertension with either losartan or atenolol.
9,193 (1195) patients mean age 67, 54% women, 25% (35%) history of vascular disease. Numbers in brackets are the the subset of patients who were diabetic at entry into the trial.
Losartan 50-100 mg PO daily or atenolol 50-100 mg PO daily. Approximately 25% required additional drugs
|CV mortality, MI, stroke (%)||All deaths||MI’s (%)||Stokes (%)||CV Mortality (%)|
|Relative Risk Reduction||15||22||Stats not done||NSS||35||Stats not done||NSS||Stats not done||29||NSS||Stats not done||NSS||Stats not done|
|Absolute Risk Reduction||2||5||6||2|
|NNT/NNH over 4.8 years||50||20||17||50|
T= total, D = diabetic, ND = nondiabetic, NSS = not statistically significant
Systolic blood pressure was lowered by 1.1 mmHg more in the losartan group compared to the atenolol group.
How does this study contribute to the drug therapy of hypertension?
This study shows that losartan decreases the chance of cardiovascular events and deaths by more (2% and 6% respectively) than atenolol in patients with hypertension. The benefit was greater in diabetic patients than in patients without diabetes. Unfortunately, thiazide diuretics, the drugs of choice for hypertension were not used as a comparison in this trial.
Dahlof B, Devereux RB, Kjeldsen SE, Julius S, Beevers G, Faire U, Fyhrquist F, Ibsen H, Kristiansson K, Lederballe-Pedersen O, Lindholm LH, Nieminen MS, Omvik P, Oparil S, Wedel H; The LIFE Study Group.Cardiovascular morbidity and mortality in the Losartan Intervention For Endpoint reduction in hypertension study (LIFE): a randomized trial against atenolol. Lancet 2002;359:995-1003
Lindholm LH, Ibsen H, Dahlof B, Devereux RB, Beevers G, de Faire U, Fyhrquist F, Julius S, Kjeldsen SE, Kristiansson K, Lederballe-Pedersen O, Nieminen MS, Omvik P, Oparil S, Wedel H, Aurup P, Edelman J, Snapinn S; The LIFE Study Group.Cardiovascular morbidity and mortality in patients with diabetes in the Losartan Intervention For Endpoint reduction in hypertension study (LIFE): a randomized trial against atenolol. Lancet 2002;359:1004-10