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Abstract

1. The Losartan Intervention For Endpoints (LIFE) reduction in hypertension study is a randomized, double-blind, prospective trial that compares the effect of losartan with those of atenolol on the reduction of cardiovascular (CV) complications in patients (n=9,194) with essential hypertension and electrocardiographically (ECG) documented left ventricular hypertrophy (LVH). Baseline blood pressure (BP) was 174.4/97.8 (mean), age 66.9 years and 54% of participants were women. BP decreased to 150.5/85.1 mmHg after 12 months and 148.5/83.9 mmHg after 24 months. 2. We assessed clinical and demographic variables at baseline as predictors of the first 694 primary composite endpoints, i.e. approximately 2/3 of the endpoints needed to conclude the study. Primary events were defined as cardiovascular death, myocardial infarction and stroke. 3. Stepwise multivariate analysis identified the following significant predictors:

4. Thus, in a large sample of patients with ECG-LVH being treated for hypertension in a large randomized outcome trial, it was possible to identify a number of clinical and demographic baseline variables that predict serious CV events. Beyond increasing age, increased CV risk is related to smoking, previous CV disease, diabetes, cholesterol, male gender, serum creatinine, and uric acid, while exercise is inversely related to risk. (See Table)

VariableChi-square valueHazard ratiop-value
Age (per year)89.61.060<0.0001
Smoking (category)50.21.220<0.0001
Diabetes33.81.758<0.0001
Prior stroke24.01.681<0.0001
Serum cholesterol (per unit)21.91.186<0.0001
Prior coronary heart disease19.61.490<0.0001
Gender (men)16.51.431<0.0001
Exercise (category)9.30.866=0.002*
Prior number of antihypertensives7.61.124=0.006
History of hypercholesterolemia7.50.758=0.006*
Serum creatinine (per unit)6.91.005=0.008
Serum uric acid (per unit)6.31.001=0.012
Body mass index4.60.981=0.032*
VariableChi-square valueHazard ratiop-value
Age (per year)89.61.060<0.0001
Smoking (category)50.21.220<0.0001
Diabetes33.81.758<0.0001
Prior stroke24.01.681<0.0001
Serum cholesterol (per unit)21.91.186<0.0001
Prior coronary heart disease19.61.490<0.0001
Gender (men)16.51.431<0.0001
Exercise (category)9.30.866=0.002*
Prior number of antihypertensives7.61.124=0.006
History of hypercholesterolemia7.50.758=0.006*
Serum creatinine (per unit)6.91.005=0.008
Serum uric acid (per unit)6.31.001=0.012
Body mass index4.60.981=0.032*
*

Inversely related risk.

VariableChi-square valueHazard ratiop-value
Age (per year)89.61.060<0.0001
Smoking (category)50.21.220<0.0001
Diabetes33.81.758<0.0001
Prior stroke24.01.681<0.0001
Serum cholesterol (per unit)21.91.186<0.0001
Prior coronary heart disease19.61.490<0.0001
Gender (men)16.51.431<0.0001
Exercise (category)9.30.866=0.002*
Prior number of antihypertensives7.61.124=0.006
History of hypercholesterolemia7.50.758=0.006*
Serum creatinine (per unit)6.91.005=0.008
Serum uric acid (per unit)6.31.001=0.012
Body mass index4.60.981=0.032*
VariableChi-square valueHazard ratiop-value
Age (per year)89.61.060<0.0001
Smoking (category)50.21.220<0.0001
Diabetes33.81.758<0.0001
Prior stroke24.01.681<0.0001
Serum cholesterol (per unit)21.91.186<0.0001
Prior coronary heart disease19.61.490<0.0001
Gender (men)16.51.431<0.0001
Exercise (category)9.30.866=0.002*
Prior number of antihypertensives7.61.124=0.006
History of hypercholesterolemia7.50.758=0.006*
Serum creatinine (per unit)6.91.005=0.008
Serum uric acid (per unit)6.31.001=0.012
Body mass index4.60.981=0.032*
*

Inversely related risk.

Atenolol, Left ventricular hypertrophy, Losartan
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© American Journal of Hypertension, Ltd. 2001
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