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Drug shown to cut stroke and death risks in form of high blood pressure

A drug that reduces high blood pressure in people with a form of the disease common later in life also cuts their risk of stroke and death, and does it better than another hypertension drug, a new study finds.

An international team of researchers reports that patients older than 55 who took a drug called losartan had a significantly lower combined rate of cardiovascular death, stroke and heart attack than similar patients taking an older drug called atenolol.

The results are from a sub-study of the Losartan Intervention for Endpoint Reduction in Hypertension, or LIFE, study, co-led by physicians from U-M.

All 1,326 men and women in the study had isolated systolic hypertension (ISH), a form of high blood pressure in which the top number in the reading is too high but the bottom number is normal. The pumping chambers of the patients’ hearts also were enlarged, a condition called left ventricular hypertrophy caused by hypertension.

ISH is the most common form of high blood pressure in middle-aged people and the elderly, but is much less likely to be controlled by medications.

In the study, the combined rate of cardiovascular death, stroke and heart attack in patients taking losartan was 25 percent lower than the risk for those taking atenolol. The rate of cardiovascular-related deaths was 46 percent lower for losartan patients, their rate of stroke was 40 percent lower, and their overall death rate was 28 percent lower.

Both groups experienced a similar drop in blood pressure, and more than 40 percent of both groups were able to reduce their blood pressure to about 140/90 mm Hg.

“This is the first demonstration that a treatment can reduce illness and death in ISH patients better than another treatment that is equally good at reducing blood pressure,” says author and LIFE study co-leader Dr. Stevo Julius. “The finding of a 40 percent reduction in stroke is especially important, because of stroke’s role as a major cause of death and disability in people with hypertension.”

Julius is the Frederick G.L. Huetwell Professor of Hypertension and professor of physiology at the Medical School, and a member of the Cardiovascular Center.

The study was funded by Merck & Co., which markets losartan by the name Cozaar.

The study’s lead author is Dr. Sverre Kjeldsen, adjunct professor of internal medicine and a hypertension specialist, who is chief of cardiology at the Ullevaal University Hospital in Oslo, Norway.

The new LIFE results add to previous evidence of losartan’s ability to cut the combined risk of cardiovascular death, stroke and heart attack by 13 percent, and stroke risk by 25 percent, in people older than 55 with all forms of hypertension. Those results, from the full LIFE group of more than 9,000 patients in seven countries, were published in March by the LIFE study group.

Losartan, introduced in 1995, is a kind of drug called an angiotensin II antagonist, which blocks the effects of a substance called angiotensin II that increases blood pressure by constricting blood vessels and causing water to be retained.

The LIFE study, which began in 1995, pitted losartan against atenolol, a member of the beta blocker class of drugs. Patients in the study were ages 55 to 80 years, with systolic (top) blood pressure readings between 160 and 200 and left ventricular hypertrophy confirmed by an electrocardiogram.

For more information, visit http://www.scandinaviancri.se/life/results/home.shtm or http://www.med.umich.edu/cvc/.





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