Effects of Losartan on Cardiovascular Morbidity and Mortality in Patients With Isolated Systolic Hypertension and Left Ventricular Hypertrophy

Abstract

These data suggest that losartan is superior to atenolol for treatment of patients with isolated systolic hypertension and ECG-LVH.

Treatment of isolated systolic hypertension in diabetes mellitus type 2

“…There were fewer fatal/non-fatal strokes in the candesartan group compared with the placebo group [7.2 vs. 12.5 per 1000 patient years, RR 0.58 (95% CI 0.33-1.0, unadjusted p ¼ 0.05, adjusted p ¼ 0.049)]. These findings support the observation in the LIFE study [44] that angiotensin receptor blockade confers specific vascular protection. The study populations in LIFE and SCOPE were selected on the basis of LVH and age, respectively, and the rate of stroke per 100 patient years was overall much higher in the LIFE study.…”

Pulse Pressure as a Risk Factor

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Isolated systolic hypertension and the J-curve of cardiovascular disease risk☆

“…It was concluded that antihypertensive therapy maximizes the decrease in SBP and minimizes the reduction in DBP in direct proportion to the age-related stiffening of large arteries. 12 Indeed, these results were confirmed in 4 large intervention studies in the elderly [SHEP, Syst-Eur, Losartan Intervention for endpoint Reduction in Hypertension study (LIFE-ISH), 13 and Hypertension in the VERY Elderly Trial (HYVET) 14 ] where there was a 3-fold greater reduction in SBP than in DBP. 15 In spite of the differential reduction of SBP and DBP in the meta-analysis of the INDANA data base, antihypertensive therapy reduced the risk of stroke and myocardial infarctions in all 3 age groups to a similar extent.…”