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  • Wachtell, K. (author)

Angiotensin II receptor blockade reduces new-onset atrial fibrillation and subsequent stroke compared to atenolol: the Losartan Intervention For End Point Reduction in Hypertension (LIFE) study

  • Article/chapterEnglish2005

Publisher, publication year, extent ...

  • Elsevier BV,2005

Numbers

  • LIBRIS-ID:oai:gup.ub.gu.se/58754
  • https://gup.ub.gu.se/publication/58754URI
  • https://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-6291URI
  • https://doi.org/10.1016/j.jacc.2004.10.068DOI

Supplementary language notes

  • Language:English

Part of subdatabase

Classification

  • Subject category:ref swepub-contenttype
  • Subject category:art swepub-publicationtype

Notes

  • OBJECTIVES: This study was designed to evaluate whether different antihypertensive treatment regimens with similar blood pressure reduction have different effects on new-onset atrial fibrillation (AF). BACKGROUND: It is unknown whether angiotensin II receptor blockade is better than beta-blockade in preventing new-onset AF. METHODS: In the Losartan Intervention For Endpoint reduction in hypertension (LIFE) study 9,193 hypertensive patients and patients with electrocardiogram-documented left ventricular hypertrophy were randomized to once-daily losartan- or atenolol-based antihypertensive therapy. Electrocardiograms were Minnesota coded centrally, and 8,851 patients without AF by electrocardiogram or history, who were thus at risk of developing AF, were followed for 4.8 +/- 1.0 years. RESULTS: New-onset AF occurred in 150 patients randomized to losartan versus 221 to atenolol (6.8 vs. 10.1 per 1,000 person-years; relative risk 0.67, 95% confidence interval [CI] 0.55 to 0.83, p < 0.001) despite similar blood pressure reduction. Patients receiving losartan tended to stay in sinus rhythm longer (1,809 +/- 225 vs. 1,709 +/- 254 days from baseline, p = 0.057) than those receiving atenolol. Moreover, patients with new-onset AF had two-, three- and fivefold increased rates, respectively, of cardiovascular events, stroke, and hospitalization for heart failure. There were fewer composite end points (n = 31 vs. 51, hazard ratio = 0.60, 95% CI 0.38 to 0.94, p = 0.03) and strokes (n = 19 vs. 38, hazard ratio = 0.49, 95% CI 0.29 to 0.86, p = 0.01) in patients who developed new-onset AF in the losartan compared to the atenolol treatment arm of the study. Furthermore, Cox regression analysis showed that losartan (21% risk reduction) and new-onset AF both independently predicted stroke even when adjusting for traditional risk factors. CONCLUSIONS: Our novel finding is that new-onset AF and associated stroke were significantly reduced by losartan- compared to atenolol-based antihypertensive treatment with similar blood pressure reduction.

Subject headings and genre

  • Adrenergic beta-Antagonists/*therapeutic use
  • Aged
  • Aged
  • 80 and over
  • Angiotensin II Type 1 Receptor Blockers/*therapeutic use
  • Atenolol/*therapeutic use
  • Atrial Fibrillation/*drug therapy/mortality
  • Cause of Death
  • Cerebrovascular Accident/*drug therapy/mortality
  • Double-Blind Method
  • Female
  • Humans
  • Hypertension/*drug therapy/mortality
  • Hypertrophy
  • Left Ventricular/*drug therapy/mortality
  • Losartan/*therapeutic use
  • Male
  • Middle Aged
  • Prospective Studies
  • Recurrence/prevention & control
  • Risk Factors
  • Survival Rate
  • Adrenergic beta-Antagonists/*therapeutic use

Added entries (persons, corporate bodies, meetings, titles ...)

  • Lehto, M. (author)
  • Gerdts, E. (author)
  • Olsen, M. H. (author)
  • Hornestam, Björn,1957Gothenburg University,Göteborgs universitet,Hjärt-kärlinstitutionen,Cardiovascular Institute(Swepub:gu)xhorbj (author)
  • Dahlöf, Björn,1953Gothenburg University,Göteborgs universitet,Hjärt-kärlinstitutionen,Cardiovascular Institute(Swepub:gu)xdahbj (author)
  • Ibsen, H. (author)
  • Julius, S. (author)
  • Kjeldsen, S. E. (author)
  • Lindholm, Lars HUmeå universitet,Allmänmedicin(Swepub:umu)lali0003 (author)
  • Nieminen, M. S. (author)
  • Devereux, R. B. (author)
  • Göteborgs universitetHjärt-kärlinstitutionen (creator_code:org_t)

Related titles

  • In:J Am Coll Cardiol: Elsevier BV45:5, s. 712-90735-1097

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