Why the study?
Does a losartan-based regimen reduce cardiovascular morbidity and mortality compared to an atenolol-based regimen in hypertensive patients with left ventricular hypertrophy?
Does a losartan-based regimen reduce cardiovascular morbidity and mortality compared to an atenolol-based regimen in hypertensive patients with left ventricular hypertrophy?
In hypertensive patients with left ventricular hypertrophy, a losartan-based regimen reduced the composite of cardiovascular death, stroke, or MI by 13% compared to an atenolol-based regimen, driven primarily by a 25% reduction in stroke.
May favor losartan over atenolol for stroke reduction in LVH hypertension; leaves open confirmation in new prospective trials.
The Losartan Intervention for Endpoint Reduction trial is one of several end-point trials that are now available with angiotensin-receptor blockers. This trial compared two regimens-losartan-based therapy to atenolol-based therapy-in 9193 hypertensive patients with electrocardiographic evidence of left ventricular hypertrophy. In the instance of each of these therapeutic groups, hydrochlorothiazide add-on therapy was permitted as per protocol. Although blood pressures were comparably reduced in both the losartan and the atenolol-based treatment groups, stroke rate was notably less in the losartan-treatment group. The 1195 patient diabetic cohort in this trial also experienced a substantial reduction in total and cardiovascular mortality favoring losartan. An additional finding in this trial was that new-onset diabetes developed 25% less frequently in the losartan-treated group. The results of this trial are both interesting and relevant to what is an expanding use of angiotensin-receptor blockers in the hypertensive population.
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Sica et al. (2002) studied this question.
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