revealed that treatment with losartan reduced the incidence of stroke by 25% compared to atenolol therapy in the four year study
LIFE study was a double-masked, randomised, parallel-group trial in more than 9000 patients with essential hypertension and electrocardiographic evidence of left ventricular hypertrophy
patients were assigned to once-daily losartan (n=4605) or once daily atenolol (n=4588) (both therapies at maximum doses of 100mg), to which diuretics and other antihypertensive drugs - with the exception of ACE inhibitors, or other angiotensin II antagonists or beta blockers - could be added, as required, to normalise BP
the trial was designed to last for at least four years and until 1040 patients had a primary cardiovascular event (death, MI or stroke)
there was a significant difference in the incidence of stroke with losartan (5%) and atenolol (7%) therapies (p=0.001); the rates of cardiovascular mortality and MI were not significantly different between the groups - however, note that the effect of losartan being the same as that of atenolol is important because it is known that atenolol therapy reduces the risk of MI by 30% in this patient population
in the diabetes subgroup (1195 patients, 586 treated with losartan), there was a 24% reduction in risk of the primary end point in the losartan group (p=0.031) and a 39% reduction in all-cause mortality (p=0.002)
the onset of diabetes was 25% less in the losartan arm
losartan and atenolol had similar BP-lowering effects
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