What question did this study set out to answer?

March 9, 2006Journal of Hypertension

Reductions in albuminuria and in electrocardiographic left ventricular hypertrophy independently improve prognosis in hypertension: the LIFE Study

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Why the study?

Do reductions in albuminuria and electrocardiographic left ventricular hypertrophy independently predict cardiovascular events in hypertensive patients?

Population

6,679 hypertensive patients from the LIFE study who did not encounter a non-fatal stroke or myocardial…

Design

Cohort

Follow-up

3-4 years after 1 year of treatment

Authors

MOMichael Hecht OlsenPreventive Cardiology KWKristian WachtellInterventional Cardiology HIHans IbsenUppsala University

Discussion

Member takes

Implication

May aid risk stratification via serial UACR and Cornell product in hypertension; leaves open whether modifying them improves outcomes.

Key Points

To determine whether reductions in urine albumin/creatinine ratio and regression of electrocardiographic left ventricular hypertrophy independently predict improved cardiovascular prognosis in hypertensive patients.
Analyzed 6679 hypertensive patients enrolled in the LIFE study treated with either a losartan- or atenolol-based regimen after a 2-week placebo run-in period.
Excluded 77 patients experiencing non-fatal stroke or myocardial infarction during the first year, following the remaining cohort for 3 to 4 years for 610 composite cardiovascular endpoints.
Measured urine albumin/creatinine ratio, Sokolow-Lyon voltage, and Cornell product at baseline and 1 year, adjusting Cox proportional hazards models for traditional risk factors and treatment allocation.
The composite endpoint was predicted by baseline logUACR (HR = 1.16 per 10-fold increase, P < 0.05), 1-year logUACR (HR = 1.29, P < 0.001), baseline Sokolow-Lyon voltage (HR = 1.01 per mm, P < 0.001), and 1-year Cornell product (HR = 1.01 per 100 mm x ms, P < 0.01).
Cardiovascular death was predicted by 1-year logUACR (HR = 1.59, P < 0.001), baseline Sokolow-Lyon voltage (HR = 1.01, P = 0.06), and 1-year Cornell product (HR = 1.02 per 100 mm x ms, P < 0.001).
Both endpoints were predicted independently of age, Framingham risk score, smoking status, diabetes, and pre-existing cardiovascular disease, whereas blood pressure and cholesterol did not enter final models.

Structured PICO

Do reductions in albuminuria and electrocardiographic left ventricular hypertrophy independently predict cardiovascular events in hypertensive patients?

Population

6,679 hypertensive patients from the LIFE study who did not encounter a non-fatal stroke or myocardial infarction during the first year of treatment

Intervention

Anti-hypertensive treatment with either an atenolol- or a losartan-based regimen

Outcome

Composite of cardiovascular death, fatal or non-fatal myocardial infarction, or stroke over 3-4 years after the first year of treatmentcomposite

Reductions in albuminuria and electrocardiographic left ventricular hypertrophy independently predict improved cardiovascular prognosis in hypertensive patients, indicating they reflect different modifiable aspects of cardiovascular damage.

Cite This Study

Olsen et al. (2006) studied this question.

synapsesocial.com/papers/6a77cf1e137c7dcc81be15ae https://doi.org/10.1097/01.hjh.0000217862.50735.dc

Topics

Hypertension management

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Reductions in albuminuria and in electrocardiographic left ventricular hypertrophy independently improve prognosis in hypertension: the LIFE Study

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Topics

Reductions in albuminuria and in electrocardiographic left ventricular hypertrophy independently improve prognosis in hypertension: the LIFE Study

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

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