Cor Vasa 2002, 43(12):537-540
AII antagonists playing a trump card - the LIFE and SCOPE trials
- II. interní klinika, Fakultní nemocnice u sv. Anny, Brno, Česká republika
AII antagonists in the treatment of hypertension have been investigated primarily in diabetic patients and in those with microalbuminuria. To date, data from four large AIIA clinical trials have been presented which demonstrated a significant renoprotective effect of these agents compared with placebo (RENAAL and IRMA) and with amlodipine (MARVAL and IDNT). The CALM trial has suggested a combination of an ACE inhibitor and an AIIA might exert an even more potent renoprotective activity. In 2002, the results of the two largest comparative trials in hypertension, LIFE (Losartan Intervention For Endpoints) and SCOPE (the Study on COgnition and Prognosis in Elderly hypertensives) were presented.
The LIFE study in 9,193 patients with documented left ventricular hypertrophy demonstrated losartan superiority over atenolol in treating stroke and new-onset diabetes mellitus, also resulting in a significantly lower endpoint (death, myocardial infarction, and stroke) (p = 0,021), while associated with the same decrease in blood pressure.
The SCOPE trial compared candesartan with another antihypertensive treatment in 4,937 hypertensives over 70 years of age. The primary endpoint, a decrease in major cardiovascular events (death, IM, stroke), reached 10.9%, not a significant difference (p = 0.19). A significant differences was seen in the incidence of stroke (p = 0.04) while the decrease in new-onset diabetes mellitus reached borderline significance.
Keywords: AII antagonists; Losartan; Candesartan; Hypertension; Diabetes mellitus
Published: November 1, 2002 Show citation