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document
[ The effect of losartan versus atenolol on cardiovascular morbidity and mortality in patients with diabetes mellitus in the LIFE-study ] . INTRODUCTION The most suitable antihypertensive drug to reduce the risk of cardiovascular disease in patients with hypertension and diabetes is unclear . In a prespecified analysis of the LIFE-study we compared the effects of losartan and atenolol on cardiovascular morbidity and mortality in diabetic patients . MATERIAL AND METHODS A total of 1195 patients in the LIFE-study had diabetes at the time of the randomisation . The patients were randomised for double-blind treatment with losartan versus atenolol . The patients had ECG-verified left ventricular hypertrophy , mean age 67 years , blood pressure 177/96 mmHg after two weeks placebo run-in period . Patients were followed for at least four years ( mean 4.7 years ) . The primary composite endpoint was cardiovascular death , stroke or myocardial infarction . RESULTS Blood pressure was reduced to 146/79 and 148/79 in losartan-treated patients and atenolol-treated patients , respectively . The primary endpoint occurred in 103 patients assigned losartan ( n = 586 ) and 139 assigned atenolol ( n = 609 ) . Relative risk reduction 24 % ( p < 0.031 ) . Cardiovascular mortality was reduced by 37 % in favour of losartan ( p < 0.028 ) , and all cause mortality by 39 % ( p < 0.002 ) . DISCUSSION Losartan was very effective in reducing cardiovascular morbidity and mortality as compared to atenolol . These results will have a major impact on the choice of anti-hypertensive treatment for patients with hypertension and diabetes .
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Intervention_Pharmacological
losartan
12080
Intervention_Pharmacological
atenolol
12081
Intervention_Pharmacological
losartan
12082
Intervention_Pharmacological
atenolol
12083
Intervention_Pharmacological
losartan
12084
Intervention_Pharmacological
atenolol
12085
Intervention_Control
placebo
12086
Intervention_Pharmacological
losartan-treated
12087
Intervention_Pharmacological
atenolol-treated
12088
Intervention_Pharmacological
losartan
12089
Intervention_Pharmacological
atenolol
12090
Intervention_Pharmacological
losartan
12091
Intervention_Pharmacological
Losartan
12092
Intervention_Pharmacological
atenolol
12093
Outcome_Physical
cardiovascular morbidity
12094
Outcome_Mortality
mortality
12095
Outcome_Physical
cardiovascular morbidity
12096
Outcome_Mortality
mortality
12097
Outcome_Mortality
cardiovascular death
12098
Outcome_Physical
, stroke or myocardial infarction
12099
Outcome_Physical
Blood pressure
12100
Outcome_Physical
Relative risk reduction
12101
Outcome_Mortality
Cardiovascular mortality
12102
Outcome_Mortality
mortality
12103
Outcome_Physical
cardiovascular morbidity
12104
Outcome_Mortality
mortality
12105
Participant_Condition
diabetes mellitus
12106
Participant_Sample-size
1195
12107
Participant_Age
67
12108
Participant_Condition
hypertension