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Original Research |

Effects of Losartan or Atenolol in Hypertensive Patients without Clinically Evident Vascular Disease: A Substudy of the LIFE Randomized Trial

Richard B. Devereux, MD; Björn Dahlöf, MD; Sverre E. Kjeldsen, MD; Stevo Julius, MD; Peter Aurup, MD; Gareth Beevers, MD; Jonathan M. Edelman, MD; Ulf de Faire, MD; Frej Fyhrquist, MD; Sigrid Helle Berg, BA; Hans Ibsen, MD; Krister Kristianson, MD; Ole Lederballe-Pedersen, MD; Lars H. Lindholm, MD; Markku S. Nieminen, MD; Per Omvik, MD; Suzanne Oparil, MD; Steven Snapinn, PhD; Hans Wedel, MD, for the LIFE Study Group*
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From the Weill Medical College of Cornell University, New York, New York; Sahlgrenska–Ostra University Hospital and The Nordic School of Public Health, Göteborg, Sweden; Ullevaal University Hospital, Oslo, Norway; University of Michigan, Ann Arbor, Michigan; Merck and Co, Inc., Whitehouse Station, New Jersey; City Hospital, Birmingham, United Kingdom; Karolinska University Hospital, Stockholm, Sweden; Helsinki University Central Hospital, Helsinki, Finland; Glostrup University Hospital, Glostrup, Denmark; Viborg Hospital, Viborg, Denmark; Umeå University, Umeå, Sweden; Haukeland University Hospital, Bergen, Norway; and the University of Alabama, Birmingham, Alabama.

Ann Intern Med. 2003;139(3):169-177. doi:10.7326/0003-4819-139-3-200308050-00006
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In this subgroup of 6886 patients without clinically evident vascular disease, which made up nearly 75% of the LIFE study sample, the primary end point occurred in 637 patients during 33 363 patient-years of follow-up. No patients were lost to follow-up before occurrence of an end point.


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Figure 1.
Systolic and diastolic blood pressure during study follow-up (intention-to-treat analysis).
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Figure 2.
Kaplan–Meier curves

. Rates of primary composite end point in patients in each treatment group.

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Figure 3.
Kaplan–Meier curvestopmiddlebottom

. Rates of occurrence in each treatment group of cardiovascular death ( ), fatal or nonfatal myocardial infarction ( ), and fatal or nonfatal stroke ( ).

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Summary for Patients

Benefits of Losartan in Patients with Hypertension and Left Ventricular Hypertrophy but No Vascular Disease

High blood pressure (hypertension) is a chronic condition that damages blood vessels and body organs. It increases the risk for heart attacks, heart failure, strokes, and kidney failure. Doctors use many types of antihypertensive drugs to treat high blood pressure. Although the drugs may reduce blood pressure to a similar extent, their ability to prevent complications of high blood pressure may vary.


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