Evidence map›Paper›PMID 11937179›Full record

Trial reportLancet (London, England)2002

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

Lars H Lindholm, Hans Ibsen, Björn Dahlöf, Richard B Devereux, Gareth Beevers, Ulf de Faire, Frej Fyhrquist, Stevo Julius, Sverre E Kjeldsen, Krister Kristiansson and 9 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 351 papers, 23 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
351citing papers in PubMed, 23 pooled it
114.9field-weighted citation impact, top 1% of its field
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
NCT02403349 phase4unknown statusnot on this mapstarted 2012, after this paper: background citation

Comparison of Peripheral and Cerebral Arterial Flow in Acute Ischemic Stroke: Fimasartan vs. Valsartan vs. Atenolol

TypeinterventionalSponsorAjou University School of MedicineRan2012 to 2015Enrolled105ConditionsBlood Pressure, Ischemic StrokeArmsFimasartan, Valsartan, Atenolol
3 · Its place in the literature

Who cites it

351 citing papers in PubMed, 23 syntheses or guidelines pooled it, 1,568 citations in OpenAlex.

  1. Guideline
  2. Guideline
  3. Pooled it
  4. Guideline
  5. Guideline
  6. Pooled it
  7. 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
  8. Pooled it
  9. Pooled it
  10. Pooled it
  11. Beta-blockers for hypertension.The Cochrane database of systematic reviews · 2017
    Pooled it
  12. Guideline
  13. Pooled it
  14. Pooled it
  15. Pooled it
  16. Pooled it
  17. Pooled it
  18. Diabetes: treating hypertension.BMJ clinical evidence · 2012
    Pooled it
  19. Pooled it
  20. Guideline

291 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

19 authors at 15 institutions in 6 countries.

Lars H LindholmUmeå University Hospital, Sweden. larsh.lindholm@fammed.umu.se
Hans Ibsen
Björn Dahlöf
Richard B Devereux
Gareth Beevers
Ulf de Faire
Frej Fyhrquist
Stevo Julius
Sverre E Kjeldsen
Krister Kristiansson
Ole Lederballe-Pedersen
Markku S Nieminen
Per Omvik
Suzanne Oparil
Hans Wedel
Peter Aurup
Jonathan Edelman
Steven Snapinn
LIFE Study Group
United States Military Academy · USHelsinki University Hospital · FIBirmingham City Hospital · GBGlostrup Hospital · DKHaukeland University Hospital · NOKarolinska University Hospital · SEMSD (Sweden) · SENewYork–Presbyterian Hospital · USNordic School of Public Health · SEOslo University Hospital · NORegionshospitalet Viborg · DKSahlgrenska University Hospital · SEUmeå University · SEUniversity of Alabama at Birmingham · USUniversity of Michigan–Ann Arbor · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe most suitable antihypertensive drug to reduce the risk of cardiovascular disease in patients with hypertension and diabetes is unclear. In prespecified analyses, we compared the effects of losartan and atenolol on cardiovascular morbidity and mortality in diabetic patients.

methodsAs part of the LIFE study, in a double-masked, randomised, parallel-group trial, we assigned a group of 1195 patients with diabetes, hypertension, and signs of left-ventricular hypertrophy (LVH) on electrocardiograms losartan-based or atenolol-based treatment. Mean age of patients was 67 years (SD 7) and mean blood pressure 177/96 mm Hg (14/10) after placebo run-in. We followed up patients for at least 4 years (mean 4.7 years [1.1]). We used Cox regression analysis with baseline Framingham risk score and electrocardiogram-LVH as covariates to compare the effects of the drugs on the primary composite endpoint of cardiovascular morbidity and mortality (cardiovascular death, stroke, or myocardial infarction).

findingsMean blood pressure fell to 146/79 mm Hg (17/11) in losartan patients and 148/79 mm Hg (19/11) in atenolol patients. The primary endpoint occurred in 103 patients assigned losartan (n=586) and 139 assigned atenolol (n=609); relative risk 0.76 (95% CI 0.58-.98), p=0.031. 38 and 61 patients in the losartan and atenolol groups, respectively, died from cardiovascular disease; 0.63 (0.42-0.95), p=0.028. Mortality from all causes was 63 and 104 in losartan and atenolol groups, respectively; 0.61 (0.45-0.84), p=0.002.

interpretationLosartan was more effective than atenolol in reducing cardiovascular morbidity and mortality as well as mortality from all causes in patients with hypertension, diabetes, and LVH. Losartan seems to have benefits beyond blood pressure reduction.

Indexed as

Angiotensin Receptor AntagonistsDiabetes ComplicationsAgedAged, 80 and overAntihypertensive AgentsAtenololCardiovascular DiseasesDouble-Blind MethodFemaleFollow-Up StudiesHumansHypertensionLosartanMaleMiddle AgedRegression AnalysisAngiotensin Receptor AntagonistsAntihypertensive AgentsAtenololLosartan

Identifiers

PMID11937179
OpenAlexW1982920623

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.