| Effects of losartan compared with atenolol on lipids in patients with hypertension and left ventricular hypertrophy: the Losartan Intervention For Endpoint reduction in hypertension study. | |
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MedLine Citation:
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PMID: 19262226 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: Beta-blockers and angiotensin II receptor blockers have different effects on lipids. METHODS: We examined lipid levels in the Losartan Intervention For Endpoint reduction in hypertension study and their impact on the primary composite endpoint of cardiovascular death, myocardial infarction, or stroke. We measured total and high-density lipoprotein cholesterol at baseline and annually during 4.8 years of losartan-based compared with atenolol-based treatment in 8611 patients with hypertension and left ventricular hypertrophy. RESULTS: Patients randomized to losartan-based or atenolol-based treatment had similar baseline total (6.04 +/- 1.12 vs. 6.05 +/- 1.13 mmol/l, NS) and high-density lipoprotein (HDL) cholesterol (1.50 +/- 0.44 vs. 1.49 +/- 0.44 mmol/l, NS). Total cholesterol decreased significantly but equally (-0.37 +/- 1.05 vs. -0.34 +/- 1.09 mmol/l, NS), whereas HDL cholesterol decreased less during the first 2 years in patients randomized to losartan compared with atenolol (-0.13 +/- 0.24 vs. -0.19 +/- 0.25 mmol/l) and remained higher each year (1.38, 1.37, 1.42, 1.47, and 1.48 mmol/l vs. 1.32, 1.30, 1.36, 1.40, and 1.42 mmol/l, all P < 0.001) independent of hydrochlorothiazide or statin treatment. In Cox regression analysis, baseline total cholesterol [hazard ratio (HR) = 1.08 (1.02-1.14) per mmol/l, P < 0.01], HDL cholesterol [HR = 0.56 (0.48-0.66) per mmol/l, P < 0.001], and treatment allocation [HR = 0.86 (0.76-0.98), P < 0.05] predicted composite endpoint independently. Using time-varying analyses, the predictive strength of HDL cholesterol was increased [HR = 0.36 (0.30-0.44) per mmol/l, P < 0.001], whereas that of total cholesterol [HR = 1.03 (0.97-1.09) per mmol/l, NS] and treatment allocation [HR = 0.91 (0.80-1.03), NS] were reduced. CONCLUSION: Losartan blunted the decrease in HDL cholesterol during antihypertensive treatment in the LIFE study. Higher intreatment HDL cholesterol was associated with fewer composite endpoints and may partly explain the better outcome of losartan-based treatment. |
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Authors:
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Michael Hecht Olsen; Kristian Wachtell; Gareth Beevers; Björn Dahlöf; Giovanni de Simone; Richard B Devereux; Ulf de Faire; Frej Fyhrquist; Hans Ibsen; Sverre E Kjeldsen; Ole Lederballe-Pedersen; Lars H Lindholm; Paulette A Lyle; Markku S Nieminen; Per Omvik; Suzanne Oparil; Hans Wedel |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Journal of hypertension Volume: 27 ISSN: 1473-5598 ISO Abbreviation: J. Hypertens. Publication Date: 2009 Mar |
Date Detail:
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Created Date: 2009-03-12 Completed Date: 2009-07-23 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8306882 Medline TA: J Hypertens Country: England |
Other Details:
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Languages: eng Pagination: 567-74 Citation Subset: IM |
Affiliation:
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Glostrup University Hospital, Glostrup, Denmark. mho@dadlnet.dk |
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Antihypertensive Agents / therapeutic use* Blood Pressure / drug effects Cardiovascular Diseases / mortality Cholesterol / blood Cholesterol, HDL / blood Diastole Dose-Response Relationship, Drug Electrocardiography Female Follow-Up Studies Humans Hypertension / complications, drug therapy* Hypertrophy, Left Ventricular / complications, drug therapy* Lipid Metabolism / drug effects* Losartan / therapeutic use* Male Middle Aged Multicenter Studies as Topic Randomized Controlled Trials as Topic Time Factors Treatment Outcome |
| Chemical | |
Reg. No./Substance:
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0/Antihypertensive Agents; 0/Cholesterol, HDL; 114798-26-4/Losartan; 57-88-5/Cholesterol |
| Comments/Corrections | |
Comment In:
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J Hypertens. 2009 Mar;27(3):458-60
[PMID:
19262224
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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