Regression of electrocardiographic left ventricular hypertrophy by losartan versus atenolol: The Losartan Intervention for Endpoint reduction in Hypertension (LIFE) Study
Electrocardiographic left ventricular hypertrophy (LVH) predicts cardiovascular morbidity and mortality, and regression of ECG LVH may predict improved prognosis in hypertensive patients. However, uncertainty persists as to how best to regress ECG LVH. Regression of ECG LVH with losartan versus aten...
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| Veröffentlicht in: | Circulation (New York, N.Y.) N.Y.), 2003-08, Vol.108 (6), p.684-690 |
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| creator | Okin, Peter M Devereux, Richard B Jern, Sverker Kjeldsen, Sverre E Julius, Stevo Nieminen, Markku S Snapinn, Steven Harris, Katherine E Aurup, Peter Edelman, Jonathan M Dahlof, Bjorn |
| description | Electrocardiographic left ventricular hypertrophy (LVH) predicts cardiovascular morbidity and mortality, and regression of ECG LVH may predict improved prognosis in hypertensive patients. However, uncertainty persists as to how best to regress ECG LVH.
Regression of ECG LVH with losartan versus atenolol therapy was assessed in 9193 hypertensive patients with ECG LVH by Sokolow-Lyon voltage or Cornell voltage-duration product criteria enrolled in the Losartan Intervention For Endpoint Reduction in Hypertension (LIFE) Study. Patients had ECGs at study baseline and after 6 months, 1, 2, 3, 4, and 5 years of blinded losartan-based or atenolol-based therapy. After 6 months' follow-up, adjusting for baseline ECG LVH levels, baseline and in-treatment systolic and diastolic pressures, and for diuretic therapy, losartan-based therapy was associated with greater regression of both Cornell product (adjusted means, -200 versus -69 mm. ms, P |
| doi_str_mv | 10.1161/01.CIR.0000083724.28630.C3 |
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Regression of ECG LVH with losartan versus atenolol therapy was assessed in 9193 hypertensive patients with ECG LVH by Sokolow-Lyon voltage or Cornell voltage-duration product criteria enrolled in the Losartan Intervention For Endpoint Reduction in Hypertension (LIFE) Study. Patients had ECGs at study baseline and after 6 months, 1, 2, 3, 4, and 5 years of blinded losartan-based or atenolol-based therapy. After 6 months' follow-up, adjusting for baseline ECG LVH levels, baseline and in-treatment systolic and diastolic pressures, and for diuretic therapy, losartan-based therapy was associated with greater regression of both Cornell product (adjusted means, -200 versus -69 mm. ms, P<0.001) and Sokolow-Lyon voltage (-2.5 versus -0.7 mm, P<0.001) than was atenolol-based therapy. Greater regression of ECG LVH persisted at each subsequent annual evaluation in the losartan-treated group, with between 140 and 164 mm. ms greater mean reductions in Cornell product and from 1.7 to 2.2 mm greater mean reductions in Sokolow-Lyon voltage (all P<0.001). The effect of losartan was consistent across subgroups defined by gender, age, ethnicity, and diabetes.
After adjusting for baseline and in-treatment blood pressure and baseline severity of ECG LVH, losartan-based antihypertensive therapy resulted in greater regression of ECG LVH by Cornell voltage-duration product and Sokolow-Lyon voltage criteria than did atenolol-based therapy. These findings support the value of angiotensin receptor blockade with losartan for reversing ECG LVH.</description><identifier>ISSN: 0009-7322</identifier><identifier>EISSN: 1524-4539</identifier><identifier>DOI: 10.1161/01.CIR.0000083724.28630.C3</identifier><identifier>PMID: 12885747</identifier><identifier>CODEN: CIRCAZ</identifier><language>eng</language><publisher>United States: American Heart Association, Inc</publisher><subject>Age Factors ; Aged ; Aged, 80 and over ; Anti-Arrhythmia Agents - therapeutic use ; Antihypertensive Agents - therapeutic use ; Atenolol - adverse effects ; Atenolol - therapeutic use ; Continental Population Groups ; Diabetes Complications ; Double-Blind Method ; Electrocardiography - drug effects ; Female ; Humans ; Hypertrophy, Left Ventricular - complications ; Hypertrophy, Left Ventricular - diagnosis ; Hypertrophy, Left Ventricular - drug therapy ; Losartan - adverse effects ; Losartan - therapeutic use ; Male ; Middle Aged ; Prospective Studies ; Remission Induction ; Risk Factors ; Sex Factors ; Treatment Outcome</subject><ispartof>Circulation (New York, N.Y.), 2003-08, Vol.108 (6), p.684-690</ispartof><rights>Copyright American Heart Association, Inc. Aug 12 2003</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c326t-ec0d151d28ed1af993af3392adcac45d842a49b3070fa785d1d32b211f2b04e3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,3687,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/12885747$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Okin, Peter M</creatorcontrib><creatorcontrib>Devereux, Richard B</creatorcontrib><creatorcontrib>Jern, Sverker</creatorcontrib><creatorcontrib>Kjeldsen, Sverre E</creatorcontrib><creatorcontrib>Julius, Stevo</creatorcontrib><creatorcontrib>Nieminen, Markku S</creatorcontrib><creatorcontrib>Snapinn, Steven</creatorcontrib><creatorcontrib>Harris, Katherine E</creatorcontrib><creatorcontrib>Aurup, Peter</creatorcontrib><creatorcontrib>Edelman, Jonathan M</creatorcontrib><creatorcontrib>Dahlof, Bjorn</creatorcontrib><creatorcontrib>Losartan Intervention for Endpoint reduction in hypertension Study Investigations</creatorcontrib><title>Regression of electrocardiographic left ventricular hypertrophy by losartan versus atenolol: The Losartan Intervention for Endpoint reduction in Hypertension (LIFE) Study</title><title>Circulation (New York, N.Y.)</title><addtitle>Circulation</addtitle><description>Electrocardiographic left ventricular hypertrophy (LVH) predicts cardiovascular morbidity and mortality, and regression of ECG LVH may predict improved prognosis in hypertensive patients. However, uncertainty persists as to how best to regress ECG LVH.
Regression of ECG LVH with losartan versus atenolol therapy was assessed in 9193 hypertensive patients with ECG LVH by Sokolow-Lyon voltage or Cornell voltage-duration product criteria enrolled in the Losartan Intervention For Endpoint Reduction in Hypertension (LIFE) Study. Patients had ECGs at study baseline and after 6 months, 1, 2, 3, 4, and 5 years of blinded losartan-based or atenolol-based therapy. After 6 months' follow-up, adjusting for baseline ECG LVH levels, baseline and in-treatment systolic and diastolic pressures, and for diuretic therapy, losartan-based therapy was associated with greater regression of both Cornell product (adjusted means, -200 versus -69 mm. ms, P<0.001) and Sokolow-Lyon voltage (-2.5 versus -0.7 mm, P<0.001) than was atenolol-based therapy. Greater regression of ECG LVH persisted at each subsequent annual evaluation in the losartan-treated group, with between 140 and 164 mm. ms greater mean reductions in Cornell product and from 1.7 to 2.2 mm greater mean reductions in Sokolow-Lyon voltage (all P<0.001). The effect of losartan was consistent across subgroups defined by gender, age, ethnicity, and diabetes.
After adjusting for baseline and in-treatment blood pressure and baseline severity of ECG LVH, losartan-based antihypertensive therapy resulted in greater regression of ECG LVH by Cornell voltage-duration product and Sokolow-Lyon voltage criteria than did atenolol-based therapy. These findings support the value of angiotensin receptor blockade with losartan for reversing ECG LVH.</description><subject>Age Factors</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Anti-Arrhythmia Agents - therapeutic use</subject><subject>Antihypertensive Agents - therapeutic use</subject><subject>Atenolol - adverse effects</subject><subject>Atenolol - therapeutic use</subject><subject>Continental Population Groups</subject><subject>Diabetes Complications</subject><subject>Double-Blind Method</subject><subject>Electrocardiography - drug effects</subject><subject>Female</subject><subject>Humans</subject><subject>Hypertrophy, Left Ventricular - complications</subject><subject>Hypertrophy, Left Ventricular - diagnosis</subject><subject>Hypertrophy, Left Ventricular - drug therapy</subject><subject>Losartan - adverse effects</subject><subject>Losartan - therapeutic use</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Prospective Studies</subject><subject>Remission Induction</subject><subject>Risk Factors</subject><subject>Sex Factors</subject><subject>Treatment Outcome</subject><issn>0009-7322</issn><issn>1524-4539</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2003</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpFkd1q3DAQhUVpabZpX6GIXLUXdvXnv9wVs2kWFgrp3gtZGmcdHMkdyQW_Up-y3s2WzI2YmTPnCD5CbjjLOS_5N8bzdveQs1PVshIqF3UpWd7KN2TDC6EyVcjmLdms-yarpBBX5EOMT2tbyqp4T664qOuiUtWG_H2AR4QYh-Bp6CmMYBMGa9AN4RHNdBwsHaFP9A_4hIOdR4P0uEyAq2w6LrRb6BiiwWT8qsE4R2oS-DCG8ZYejkD3_7c7nwBPNqesPiDdejeFwSeK4GZ7Hg-e3p_NwZ-_9GW_u9t-pb_S7JaP5F1vxgifLu81OdxtD-19tv_5Y9d-32dWijJlYJnjBXeiBsdN3zTS9FI2wjhrrCpcrYRRTSdZxXpT1YXjTopOcN6LjimQ1-TmxXbC8HuGmPRTmNGviVpwUZYFV80qun0RWQwxIvR6wuHZ4KI50ydImnG9QtKvkPQZkm7levz5kjB3z-BeTy9U5D-W3pKv</recordid><startdate>20030812</startdate><enddate>20030812</enddate><creator>Okin, Peter M</creator><creator>Devereux, Richard B</creator><creator>Jern, Sverker</creator><creator>Kjeldsen, Sverre E</creator><creator>Julius, Stevo</creator><creator>Nieminen, Markku S</creator><creator>Snapinn, Steven</creator><creator>Harris, Katherine E</creator><creator>Aurup, Peter</creator><creator>Edelman, Jonathan M</creator><creator>Dahlof, Bjorn</creator><general>American Heart Association, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>U9A</scope></search><sort><creationdate>20030812</creationdate><title>Regression of electrocardiographic left ventricular hypertrophy by losartan versus atenolol: The Losartan Intervention for Endpoint reduction in Hypertension (LIFE) Study</title><author>Okin, Peter M ; Devereux, Richard B ; Jern, Sverker ; Kjeldsen, Sverre E ; Julius, Stevo ; Nieminen, Markku S ; Snapinn, Steven ; Harris, Katherine E ; Aurup, Peter ; Edelman, Jonathan M ; Dahlof, Bjorn</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c326t-ec0d151d28ed1af993af3392adcac45d842a49b3070fa785d1d32b211f2b04e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2003</creationdate><topic>Age Factors</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Anti-Arrhythmia Agents - therapeutic use</topic><topic>Antihypertensive Agents - therapeutic use</topic><topic>Atenolol - adverse effects</topic><topic>Atenolol - therapeutic use</topic><topic>Continental Population Groups</topic><topic>Diabetes Complications</topic><topic>Double-Blind Method</topic><topic>Electrocardiography - drug effects</topic><topic>Female</topic><topic>Humans</topic><topic>Hypertrophy, Left Ventricular - complications</topic><topic>Hypertrophy, Left Ventricular - diagnosis</topic><topic>Hypertrophy, Left Ventricular - drug therapy</topic><topic>Losartan - adverse effects</topic><topic>Losartan - therapeutic use</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Prospective Studies</topic><topic>Remission Induction</topic><topic>Risk Factors</topic><topic>Sex Factors</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Okin, Peter M</creatorcontrib><creatorcontrib>Devereux, Richard B</creatorcontrib><creatorcontrib>Jern, Sverker</creatorcontrib><creatorcontrib>Kjeldsen, Sverre E</creatorcontrib><creatorcontrib>Julius, Stevo</creatorcontrib><creatorcontrib>Nieminen, Markku S</creatorcontrib><creatorcontrib>Snapinn, Steven</creatorcontrib><creatorcontrib>Harris, Katherine E</creatorcontrib><creatorcontrib>Aurup, Peter</creatorcontrib><creatorcontrib>Edelman, Jonathan M</creatorcontrib><creatorcontrib>Dahlof, Bjorn</creatorcontrib><creatorcontrib>Losartan Intervention for Endpoint reduction in hypertension Study Investigations</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><jtitle>Circulation (New York, N.Y.)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Okin, Peter M</au><au>Devereux, Richard B</au><au>Jern, Sverker</au><au>Kjeldsen, Sverre E</au><au>Julius, Stevo</au><au>Nieminen, Markku S</au><au>Snapinn, Steven</au><au>Harris, Katherine E</au><au>Aurup, Peter</au><au>Edelman, Jonathan M</au><au>Dahlof, Bjorn</au><aucorp>Losartan Intervention for Endpoint reduction in hypertension Study Investigations</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Regression of electrocardiographic left ventricular hypertrophy by losartan versus atenolol: The Losartan Intervention for Endpoint reduction in Hypertension (LIFE) Study</atitle><jtitle>Circulation (New York, N.Y.)</jtitle><addtitle>Circulation</addtitle><date>2003-08-12</date><risdate>2003</risdate><volume>108</volume><issue>6</issue><spage>684</spage><epage>690</epage><pages>684-690</pages><issn>0009-7322</issn><eissn>1524-4539</eissn><coden>CIRCAZ</coden><abstract>Electrocardiographic left ventricular hypertrophy (LVH) predicts cardiovascular morbidity and mortality, and regression of ECG LVH may predict improved prognosis in hypertensive patients. However, uncertainty persists as to how best to regress ECG LVH.
Regression of ECG LVH with losartan versus atenolol therapy was assessed in 9193 hypertensive patients with ECG LVH by Sokolow-Lyon voltage or Cornell voltage-duration product criteria enrolled in the Losartan Intervention For Endpoint Reduction in Hypertension (LIFE) Study. Patients had ECGs at study baseline and after 6 months, 1, 2, 3, 4, and 5 years of blinded losartan-based or atenolol-based therapy. After 6 months' follow-up, adjusting for baseline ECG LVH levels, baseline and in-treatment systolic and diastolic pressures, and for diuretic therapy, losartan-based therapy was associated with greater regression of both Cornell product (adjusted means, -200 versus -69 mm. ms, P<0.001) and Sokolow-Lyon voltage (-2.5 versus -0.7 mm, P<0.001) than was atenolol-based therapy. Greater regression of ECG LVH persisted at each subsequent annual evaluation in the losartan-treated group, with between 140 and 164 mm. ms greater mean reductions in Cornell product and from 1.7 to 2.2 mm greater mean reductions in Sokolow-Lyon voltage (all P<0.001). The effect of losartan was consistent across subgroups defined by gender, age, ethnicity, and diabetes.
After adjusting for baseline and in-treatment blood pressure and baseline severity of ECG LVH, losartan-based antihypertensive therapy resulted in greater regression of ECG LVH by Cornell voltage-duration product and Sokolow-Lyon voltage criteria than did atenolol-based therapy. These findings support the value of angiotensin receptor blockade with losartan for reversing ECG LVH.</abstract><cop>United States</cop><pub>American Heart Association, Inc</pub><pmid>12885747</pmid><doi>10.1161/01.CIR.0000083724.28630.C3</doi><tpages>7</tpages></addata></record> |
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| subjects | Age Factors Aged Aged, 80 and over Anti-Arrhythmia Agents - therapeutic use Antihypertensive Agents - therapeutic use Atenolol - adverse effects Atenolol - therapeutic use Continental Population Groups Diabetes Complications Double-Blind Method Electrocardiography - drug effects Female Humans Hypertrophy, Left Ventricular - complications Hypertrophy, Left Ventricular - diagnosis Hypertrophy, Left Ventricular - drug therapy Losartan - adverse effects Losartan - therapeutic use Male Middle Aged Prospective Studies Remission Induction Risk Factors Sex Factors Treatment Outcome |
| title | Regression of electrocardiographic left ventricular hypertrophy by losartan versus atenolol: The Losartan Intervention for Endpoint reduction in Hypertension (LIFE) Study |
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