Document Detail


Regression of electrocardiographic left ventricular hypertrophy by losartan versus atenolol: The Losartan Intervention for Endpoint reduction in Hypertension (LIFE) Study.
MedLine Citation:
PMID:  12885747     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Electrocardiographic left ventricular hypertrophy (LVH) predicts cardiovascular morbidity and mortality, and regression of ECG LVH may predict improved prognosis in hypertensive patients. However, uncertainty persists as to how best to regress ECG LVH. METHODS AND RESULTS: Regression of ECG LVH with losartan versus atenolol therapy was assessed in 9193 hypertensive patients with ECG LVH by Sokolow-Lyon voltage or Cornell voltage-duration product criteria enrolled in the Losartan Intervention For Endpoint Reduction in Hypertension (LIFE) Study. Patients had ECGs at study baseline and after 6 months, 1, 2, 3, 4, and 5 years of blinded losartan-based or atenolol-based therapy. After 6 months' follow-up, adjusting for baseline ECG LVH levels, baseline and in-treatment systolic and diastolic pressures, and for diuretic therapy, losartan-based therapy was associated with greater regression of both Cornell product (adjusted means, -200 versus -69 mm. ms, P<0.001) and Sokolow-Lyon voltage (-2.5 versus -0.7 mm, P<0.001) than was atenolol-based therapy. Greater regression of ECG LVH persisted at each subsequent annual evaluation in the losartan-treated group, with between 140 and 164 mm. ms greater mean reductions in Cornell product and from 1.7 to 2.2 mm greater mean reductions in Sokolow-Lyon voltage (all P<0.001). The effect of losartan was consistent across subgroups defined by gender, age, ethnicity, and diabetes. CONCLUSIONS: After adjusting for baseline and in-treatment blood pressure and baseline severity of ECG LVH, losartan-based antihypertensive therapy resulted in greater regression of ECG LVH by Cornell voltage-duration product and Sokolow-Lyon voltage criteria than did atenolol-based therapy. These findings support the value of angiotensin receptor blockade with losartan for reversing ECG LVH.
Authors:
Peter M Okin; Richard B Devereux; Sverker Jern; Sverre E Kjeldsen; Stevo Julius; Markku S Nieminen; Steven Snapinn; Katherine E Harris; Peter Aurup; Jonathan M Edelman; Bjorn Dahlof;
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't     Date:  2003-07-28
Journal Detail:
Title:  Circulation     Volume:  108     ISSN:  1524-4539     ISO Abbreviation:  Circulation     Publication Date:  2003 Aug 
Date Detail:
Created Date:  2003-08-12     Completed Date:  2003-09-17     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  United States    
Other Details:
Languages:  eng     Pagination:  684-90     Citation Subset:  AIM; IM    
Affiliation:
Department of Medicine, Cornell University Medical Center, 525 East 68th St, New York, NY 10021, USA. pokin@mail.med.cornell.edu
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MeSH Terms
Descriptor/Qualifier:
Age Factors
Aged
Aged, 80 and over
Anti-Arrhythmia Agents / therapeutic use
Antihypertensive Agents / therapeutic use
Atenolol / adverse effects,  therapeutic use*
Continental Population Groups
Diabetes Complications
Double-Blind Method
Electrocardiography / drug effects*
Female
Humans
Hypertrophy, Left Ventricular / complications,  diagnosis,  drug therapy*
Losartan / adverse effects,  therapeutic use*
Male
Middle Aged
Prospective Studies
Remission Induction
Risk Factors
Sex Factors
Treatment Outcome
Chemical
Reg. No./Substance:
0/Anti-Arrhythmia Agents; 0/Antihypertensive Agents; 114798-26-4/Losartan; 29122-68-7/Atenolol

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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