ZOMBIE-NATIONh y p e r t e n s I v e n a t I o n

By

DR. ABDUL RAB SHAIKHConsultant Interventional Cardiologist

RED CRESCENT INSTITUTE OF CARDIOLOGY

@

RED CRESCENT INSTITUTE OF CARDIOLOGY26TH NOVEMBER , MONDAY , 2012

A person whose behavior or responses are wooden,listless, or seemingly rote; automaton.

what are the similarities between a zombie and hypertensives?

Who wants to be zombie ????

what measures we take to become a ANGEL!

The LIFE Trial

Losartan Intervention For Endpoint reduction in hypertension study (LIFE)

Presented at the American College of Cardiology

51st Annual Scientific Session

Atlanta, GA

Patients with hypertension (blood pressure 160-200/ 95-115 mm Hg) and left ventricular hypertrophy

AtenololBeta-blocker

Dose titrated to BP <140/90 mm Hg

(n=4,588)

LosartanAngiotensin II antagonist

Dose titrated to BP <140/90 mm Hg

(n=4,605)

Followed for >4 years - Mean follow-up 4.8 years

Cardiovascular death, MI, stroke

LIFE: Study Design

11.0%

12.8%

0%

5%

10%

15%

Losartan Atenolol

P=0.021

Composite of CV Death / MI / StrokeLIFE: Primary Composite Endpoint

Adjusted Hazard Ratio =

0.87

Rate 23.8/1,000 patient yrs

Rate 27.9/1,000 patient yrs

n=508 n=588

4.4%

5.1%

0%

2%

4%

6%

8%

5.0%

6.7%

0%

2%

4%

6%

8%

4.3% 4.1%

0%

2%

4%

6%

8%

P=0.206 P=0.491

Cardiovascular Death Myocardial Infarction

P=0.001

Stroke

LIFE: Individual Endpoint Results

Adjusted HR 0.89

Adjusted HR 1.07

Adjusted HR 0.75

Losartan Atenolol Losartan Atenolol Losartan Atenolol

5.2%

7.0%

0%

2%

4%

6%

8%

10%

Losartan Atenolol

P=0.001

LIFE: New-onset diabetes

Adjusted Hazard Ratio =

0.75

Rate 13.0/1,000 patient yrs

Rate 17.4/1,000 patient yrs

n=241 n=319