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The Pharmaceutical Journal
Vol 268 No 7190 p385-391
23 March 2002

Related websites
The Lancet (www.thelancet.com)

The meaning of LIFE

"Losartan is not just as good as, but is better than, atenolol in stroke prevention," said Professor Gareth Beevers, City Hospital, Birmingham, this week. Professor Beevers was speaking at a meeting to announce the results of the LIFE (losartan intervention for endpoint reduction) study in hypertension, published in The Lancet this week (2002;359:995).

The primary aim of the study was to evaluate the long-term effects of losartan compared with atenolol in patients with left ventricular hypertrophy (LVH) and hypertension on the combined likelihood of morbidity and mortality (defined as sudden death or death due to heart attack, stroke, progressive heart failure or other cardiovascular causes). The study took place over four years at more than 800 centres in the United Kingdom, United States and Scandinavia, and involved over 9,000 patients. The results show that losartan reduces the risk of stroke by 25 per cent compared with atenolol (P=0.001) and that the combined heart attack and stroke rate is reduced by 13 per cent (P=0.02). The study results suggest that the antihypertensive effect of both drugs is comparable but that losartan is better tolerated with fewer side effects.

Dr Andrew Wijnburg, a general practitioner and LIFE investigator, said that losartan should now be the gold standard for treatment of hypertension.

Reducing risks in diabetes In a second study also published in this week's issue of The Lancet, the LIFE investigators compared the efficacy of losartan and atenolol in patients who had diabetes in addition to hypertension and LVH. Losartan reduced the risk of cardiovascular death, stroke, and myocardial infarction by around 25 per cent and the risk of cardiovascular death alone by 37 per cent (ibid, p1004).