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Losartan versus atenolol on 24-hour ambulatory blood pressure. A LIFE substudy

Lia E Bang1, Niels Wiinberg, Kristian Wachtell

  • 1Naestved Hospital, Naestved, Denmark.

Blood Pressure
|December 7, 2007
PubMed

Insights

Losartan and atenolol equally reduced 24-hour blood pressure (BP) and heart rate (HR) in hypertensive patients. This study found no significant differences in BP or HR to explain losartan

Area of Science:

  • Cardiology
  • Hypertension Research
  • Pharmacology

Background:

  • The Losartan Intervention For Endpoint reduction in hypertension (LIFE) study previously demonstrated losartan's superiority over atenolol in reducing cardiovascular events in hypertensive patients with left ventricular hypertrophy.
  • Both treatment strategies achieved similar reductions in office blood pressure (BP).

Purpose of the Study:

  • To investigate the comparative effects of losartan-based versus atenolol-based treatment on 24-hour ambulatory blood pressure (BP) and heart rate (HR) in the LIFE study.
  • To explore potential mechanisms for the observed outcome differences between the two antihypertensive drug classes.

Main Methods:

  • A subset of 110 patients from the LIFE study underwent 24-hour ambulatory BP and HR monitoring.
  • Measurements were taken at baseline and after 1 year of treatment with either losartan or atenolol.

Main Results:

  • Both losartan and atenolol comparably reduced 24-hour ambulatory BP throughout the entire day-night cycle after one year.
  • While both treatments lowered office and ambulatory BP similarly, the 'non-dipping' phenomenon (lack of nocturnal BP fall) was more prevalent in the losartan group.
  • The 24-hour HR profile remained unchanged with losartan, whereas atenolol significantly decreased daytime HR, with a less pronounced effect during early night-time.

Conclusions:

  • The comparable 24-hour BP and HR profiles observed between losartan- and atenolol-based treatments do not fully explain the superior cardiovascular outcomes associated with losartan in the LIFE study.
  • Further research is needed to elucidate the mechanisms behind losartan's improved clinical efficacy in this patient population.
Abstract

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