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Losartan reduced cardiovascular morbidity and mortality more than atenolol in patients with diabetes and essential hypertension

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 QUESTION: In patients with diabetes, essential hypertension, and signs of left ventricular hypertrophy (LVH), is losartan-based therapy more effective than atenolol-based therapy?


Randomised (unclear allocation concealment*), blinded (patients and monitoring committee),* controlled trial with ≥4 years follow up.


Multicentre trial in Europe and the United States.


1195 patients (a predefined subgroup of patients who had diabetes mellitus at the start of the LIFE study) who were 55 to 80 years of age (mean age 67 y, 53% women) with hypertension (sitting blood pressure [BP] after 1 to 2 wks of placebo of 160 to 200 mm Hg systolic, 95 to 115 mm Hg diastolic, or both) and electrocardiographical signs of LVH. Exclusion criteria included secondary hypertension; myocardial infarction (MI) or stroke within the previous 6 months; angina pectoris requiring treatment with β-blockers or calcium antagonists; and heart failure or left ventricular ejection fraction ≤40%. Follow up was 100%.


Patients were allocated to losartan based therapy (n = 586) or …

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  • Source of funding: Merck.

  • For correspondence: Professor LH Lindholm, Umeå University Hospital, Umeå, Sweden. E-mail larsh.lindholm{at}

  • * See glossary.