Evidence map›Paper›PMID 11937178›Full record

Trial reportLancet (London, England)2002

Cardiovascular morbidity and mortality in the Losartan Intervention For Endpoint reduction in hypertension study (LIFE): a randomised trial against atenolol.

Björn Dahlöf, Richard B Devereux, Sverre E Kjeldsen, Stevo Julius, Gareth Beevers, Ulf de Faire, Frej Fyhrquist, Hans Ibsen, Krister Kristiansson, Ole Lederballe-Pedersen and 6 more

2 registry-linked trialsAbstract readClinical TrialComparative StudyRandomized Controlled Trial
PubMed Publisher
In one paragraph

Trial report in Lancet (London, England), 2002. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 1,177 papers, 19 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
1,177citing papers in PubMed, 19 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT00338260 phase3completednot on this map

A Triple-Blind, Parallel Study to Investigate the Effect of Losartan Versus Atenolol on the Reduction of Morbidity and Mortality in Hypertensive Patients With Left Ventricular Hypertrophy

TypeinterventionalSponsorOrganon and CoRan1995 to 2001Enrolled496ConditionsHypertension and Left Ventricular Hypertrophy (Thickening of the Main Pumping Chamber of the Heart)ArmsMK0954, /Duration of Treatment : 5 Years, Comparator : atenolol /Duration of Treatment : 5 Years
NCT05745337 phase1unknown statusnot on this mapstarted 2023, after this paper: background citation

Improving Outcomes in Atrial Fibrillation Patients Aided by Implantable Cardiac Monitor: Evaluation of Chronic Beta-blocker Use Versus As-needed Pharmacological Rate Control

TypeinterventionalSponsorUniversity of VermontRan2023 to 2025Enrolled20ConditionsAtrial Fibrillation, Diastolic Dysfunction, HFpEF - Heart Failure With Preserved Ejection FractionArmsAs needed pharmacological rate control with beta-blocker (metoprolol tartrate, metoprolol succinate) or calcium channel blocker (diltiazem, verapamil)
3 · Its place in the literature

Who cites it

1,177 citing papers in PubMed, 19 syntheses or guidelines pooled it.

  1. Pooled it
  2. Efficacy and Safety of ARB-Based Combination Therapies for Treatment of Hypertension: A Systematic Review and Meta-analyses.High blood pressure & cardiovascular prevention : the official journal of the Italian Society of Hypertension · 2026
    Pooled it
  3. Guideline
  4. Pooled it
  5. Pooled it
  6. Guideline
  7. Pooled it
  8. Pooled it
  9. Pooled it
  10. American Association of Clinical Endocrinology Clinical Practice Guideline: Developing a Diabetes Mellitus Comprehensive Care Plan-2022 Update.Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists · 2022
    Guideline
  11. Pooled it
  12. Pooled it
  13. Pooled it
  14. Pooled it
  15. Pooled it
  16. Guideline
  17. Guideline
  18. The Japanese Society of Hypertension Guidelines for the Management of Hypertension (JSH 2019).Hypertension research : official journal of the Japanese Society of Hypertension · 2019
    Guideline
  19. Pooled it
  20. Trial

1,117 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

16 authors.

Björn DahlöfSahlgrenska University Hospital/Ostra, Gothenburg, Swede. bdahlof@scandinaviancri.se
Richard B Devereux
Sverre E Kjeldsen
Stevo Julius
Gareth Beevers
Ulf de Faire
Frej Fyhrquist
Hans Ibsen
Krister Kristiansson
Ole Lederballe-Pedersen
Lars H Lindholm
Markku S Nieminen
Per Omvik
Suzanne Oparil
Hans Wedel
LIFE Study Group

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundBlood pressure reduction achieved with beta-blockers and diuretics is the best recorded intervention to date for prevention of cardiovascular morbidity and death in patients with hypertension. Left ventricular hypertrophy (LVH) is a strong independent indicator of risk of cardiovascular morbidity and death. We aimed to establish whether selective blocking of angiotensin II improves LVH beyond reducing blood pressure and, consequently, reduces cardiovascular morbidity and death.

methodsWe did a double-masked, randomised, parallel-group trial in 9193 participants aged 55-80 years with essential hypertension (sitting blood pressure 160-200/95-115 mm Hg) and LVH ascertained by electrocardiography (ECG). We assigned participants once daily losartan-based or atenolol-based antihypertensive treatment for at least 4 years and until 1040 patients had a primary cardiovascular event (death, myocardial infarction, or stroke). We used Cox regression analysis to compare regimens.

findingsBlood pressure fell by 30.2/16.6 (SD 18.5/10.1) and 29.1/16.8 mm Hg (19.2/10.1) in the losartan and atenolol groups, respectively. The primary composite endpoint occurred in 508 losartan (23.8 per 1000 patient-years) and 588 atenolol patients (27.9 per 1000 patient-years; relative risk 0.87, 95% CI 0.77-0.98, p=0.021). 204 losartan and 234 atenolol patients died from cardiovascular disease (0.89, 0.73-1.07, p=0.206); 232 and 309, respectively, had fatal or non-fatal stroke (0.75, 0.63-0.89, p=0.001); and myocardial infarction (non-fatal and fatal) occurred in 198 and 188, respectively (1.07, 0.88-1.31, p=0.491). New-onset diabetes was less frequent with losartan. Interpretation Losartan prevents more cardiovascular morbidity and death than atenolol for a similar reduction in blood pressure and is better tolerated. Losartan seems to confer benefits beyond reduction in blood pressure.

Indexed as

Angiotensin Receptor AntagonistsAgedAged, 80 and overAntihypertensive AgentsAtenololCardiovascular DiseasesDiabetes ComplicationsDouble-Blind MethodFemaleHumansHypertensionLosartanMaleMiddle AgedAngiotensin Receptor AntagonistsAntihypertensive AgentsAtenololLosartan

Identifiers

PMID11937178

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.