Characteristics of 9194 Patients With Left Ventricular Hypertrophy
- 1 December 1998
- journal article
- research article
- Published by Ovid Technologies (Wolters Kluwer Health) in Hypertension
- Vol. 32 (6), 989-997
- https://doi.org/10.1161/01.hyp.32.6.989
Abstract
Abstract —Losartan was the first available orally administered selective antagonist of the angiotensin II type 1 receptor developed for the treatment of hypertension. The Losartan Intervention For Endpoint (LIFE) Reduction in Hypertension Study is a double-blind, prospective, parallel group study designed to compare the effects of losartan with those of the β-blocker atenolol on the reduction of cardiovascular morbidity and mortality. Patients with essential hypertension, aged between 55 and 80 years, and ECG-documented left ventricular hypertrophy (LVH) were included. Altogether, 9223 patients in Scandinavia, the United Kingdom, and the United States were randomized from June 1995 through April 1997, and 9194 remain after exclusion of a study center at which irregularities were discovered. This population of hypertensives (mean systolic/diastolic blood pressure, 174.4/97.8 mm Hg) with LVH comprises women (54.1%) and men, mostly retired from active work (mean age, 66.9 years), with a high prevalence of overweight (mean body mass index, 28.0 kg/m 2 ), diabetes mellitus (12.3%), lipid disorders (18.0%), and symptoms or signs of coronary heart disease (15.1%). There were fewer current smokers (<17%) than in the general population, and ≈7% were nonwhite. Almost 30% of participants had been untreated for at least 6 months when screened for the study. Only 1557 persons who entered the placebo run-in period of 14 days were excluded, predominantly because of sitting blood pressures above or below the predetermined range of 160-200/95-115 mm Hg and ECG-LVH criteria not met. By application of simple 12-lead ECG criteria for LVH (Cornell voltage QRS duration product formula plus Sokolow-Lyon voltage read by a core laboratory), hypertensive patients with LVH with an average 5-year coronary heart disease risk of 22.3% according to the Framingham score were identified. This population is now being treated (goal, <140/90 mm Hg) in adherence with the protocol for at least 4 years after final enrollment (ie, through April 2001) and until at least 1040 patients suffer myocardial infarction, stroke, or cardiovascular death.Keywords
This publication has 18 references indexed in Scilit:
- Randomised trial of losartan versus captopril in patients over 65 with heart failure (Evaluation of Losartan in the Elderly Study, ELITE)The Lancet, 1997
- Predictors of 7-year changes in exercise blood pressureJournal of Hypertension, 1997
- How smoking affects blood pressureBlood Pressure, 1996
- Safety and tolerability of losartan potassium, an angiotensin II receptor antagonist, compared with hydrochlorothiazide, atenolol, felodipne ER, and angiotensin-converting enzyme inhibitors for the treatment of systemic hypertensionThe American Journal of Cardiology, 1995
- Electrocardiographic identification of increased left ventricular mass by simple voltage-duration productsJournal of the American College of Cardiology, 1995
- 1993 Guidelines for the management of mild hypertension: memorandum from a World Health Organization/International Society of Hypertension meetingJournal of Hypertension, 1993
- Electrocardiographic detection of left ventricular hypertrophy by the simple QRS voltage-duration productJournal of the American College of Cardiology, 1992
- Morbidity and mortality in the Swedish Trial in Old Patients with Hypertension (STOP-Hypertension)The Lancet, 1991
- Prognostic Implications of Echocardiographically Determined Left Ventricular Mass in the Framingham Heart StudyThe New England Journal of Medicine, 1990
- The ventricular complex in left ventricular hypertrophy as obtained by unipolar precordial and limb leadsAmerican Heart Journal, 1949