Losartan was associated with marked reductions in stroke and new-onset diabetes, compared with atenolol, in a landmark clinical trial of patients with hypertension.
"I think these results have immediate applicability to clinical practice. The message is that it matters how you lower blood pressure. We now have a treatment with benefit beyond blood pressure lowering," Dr. Bjorn Dahlof said at the annual meeting of the American College of Cardiology.
A total of 9,197 American, Scandinavian, and British patients with essential hypertension and left ventricular hypertrophy, all older than age 55, were randomized to either 50-100 mg/day of the angiotensin receptor blocker (ARB) losartan or the [beta]-blocker atenolol, with hydrochlorothiazide added as needed to reach blood pressure goals.
Achieved blood pressures were virtually identical in the two groups.
After a mean 4.8 years of therapy in the double-blind trial, which was sponsored by Merck & Co., patients in the losartan group had a highly significant 13% reduction in the composite primary study end point--cardiovascular death, stroke, or acute MI--compared with those on atenolol.
There was a 25% reduction in strokes with the ARB beyond the reduction achieved with [beta]-blocker therapy The losartan group also had an 11.4% greater reduction in cardiovascular mortality and a 7.3% reduction in acute MIs, compared with the atenolol group, neither of which reached statistical significance.
Losartan-treated patients had a striking 25% reduction in new-onset diabetes. Losartan also significantly reduced left ventricular hypertrophy, based on annual ECG results, said Dr. Dahlof, who is chair of the trial and a cardiologist at the University of Goteborg (Sweden).
COPYRIGHT 2002 International Medical News Group
COPYRIGHT 2002 Gale Group
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