Losartan reduced stroke and new onset diabetes more than atenolol in essential hypertension with signs of left ventricular hypertrophy
QUESTION: In patients with essential hypertension and signs of left ventricular hypertrophy (LVH), is losartan based treatment more effective than atenolol based treatment?
Randomised (unclear allocation concealment), blinded (patients and monitoring committee), controlled trial with ≥4 years of follow up.
Multicentre trial in Europe and the US.
9222 patients 55–80 years of age (mean age 67 y, 54% women) with hypertension (sitting blood pressure [BP] of 160–200 mm Hg systolic, 95–115 mm Hg diastolic, or both after 1–2 wks of placebo) and electrocardiographic 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 99%.