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Title: LIFE studies in hypertensive pts in reducing various cv morbidities & mortalities including stroke

Authors: Manan K Trivedi

Topic: Clinical Research

Abstract:

OBJECTIVE:

Main objective of the article is to critically assess and analyze beneficial effects of losartan Vs. atenolol along with its safety and efficacy profile in different composite endpoints of CV morbidities and mortalities like MI, stroke, ISH, AF and new onset of diabetes and in comparison to atenolol group in hypertensive patients. Also to assess such beneficial effects in combination therapy of losartan and aspirin on the same outcomes.

DESIGN & METHODOLOGY:

Relevant randomized clinical trials and review articles were identified through a MEDLINE search of English-language articles published between 1990 and 2013 using the search terms losartan, atenolol, LIFE, hypertension, and LVH. Articles describing major clinical studies, new data, or mechanisms pertinent to the LIFE study were selected for review. Total of 7 such clinical studies are reviewed and analyzed for its results.

The LIFE-study included 9193 patients with essential hypertension and ECG-verified left ventricular hypertrophy, age range 55-80 years. Patients were randomized to double-blind treatment with losartan vs. atenolol. They were followed for at least four years and until 1040 patients had a primary cardiovascular event.

RESULTS:

Losartan attained 33% reduction in new onset of AF with subsequent stroke vs. atenolol. Results of these studies shows there were 45% reduced rate of stroke events. There was no difference in MI.  New onset of diabetes was 25% less frequent on losartan. Side effects were less on losartan vs. atenolol

CONCLUSION:

LIFE studies justified efficacy and safety profile of losartan against atenolol in not only stroke but also other cardiovascular morbidities and mortalities with similar composite endpoint reduction in combination therapy of losartan with aspirin.

KEYWORDS: LIFE (Losartan Intervention For Endpoint reduction in hypertension), ISH (isolated systolic hypertension), MI (Myocardial Infarction), AF (Atrial fibrillation), LVH (Left Ventricular Hypertrophy), CV (Cardiovascular)

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    COMMENT - 1

  • CHRISTINA HENRY PEREIRA (Viewer) 28th Jan 2015 - 12:05 PM
    Hello Manan Trivedi, it appears that you have done a detailed review of articles covering the use of losartan and a comparative study such as this would be significant for evidence-based medicine and medical practice. However, I wonder if it were possible to perform a meta-analysis of these studies, to give a composite view of all parameters against which losartan in combination with other drugs or alone to make a final case for or against losartan. I felt that the presentation of data pictorially would be easier to read and appreciate than just paragraphs of text. A second observation is that the title is a bit lengthy. A more concise title would be preferable. Thank you for the informative review.
    • MANAN K TRIVEDI (Author) 5th Feb 2015 - 4:46 PM
      @ Michael...Thanks for your suggestion. Due to article's word limit i couldn't do much on that but if you see reference number and discussion i have quoted each and every article which i have taken for review.

  • COMMENT - 2

  • Michael Sello Seahloli (Viewer) 1st Feb 2015 - 11:55 PM
    The article was well written and structured. However the article did not explain how data was attained and may be should have added a table with list of trials referenced. Otherwise the article was done well. Lastly in Losartan is a very good drug and it will be interesting to compare losartan and Lercandipine because it is claiming the same effect and safety profile.

  • COMMENT - 3

  • MANAN K TRIVEDI (Author) 5th Feb 2015 - 4:46 PM
    @Thanks Christina I agree for EBM Meta-analysis is important which was already done on LIFE studies but i have covered recently added studies in 2012 and 2013 to support previous research articles. Regarding title i already have comprised it by giving short forms but still as LIFE and comparison way i couldn't shorter much on the same!

  • COMMENT - 4

  • JOSEPH WILLIAM WADAKKAN (Viewer) 7th Feb 2015 - 10:29 PM
    Hi trivedi,
    Life studies in hypertension article review is very beneficial to the medical professionals.In the present article reduction in blood pressure comparison between losartan with ASA and Atenolol with ASA not mentioned in detailed way. Main use of both medicine are anti hypertensive activity.Choosing the title for the article required more concern.

  • COMMENT - 5

  • RAHUL TULSHIRAM INGALE (Viewer) 9th Feb 2015 - 6:06 PM
    Hello Trivedi,

    Very good topic to discuss. More research would be very beneficial but can understand the word limit for the paper.

    Regards,

    Rahul.

  • COMMENT - 6

  • RAHUL TULSHIRAM INGALE (Viewer) 9th Feb 2015 - 6:06 PM
    Hello Trivedi,

    Very good topic to discuss. More research would be very beneficial but can understand the word limit for the paper.

    Regards,

    Rahul.