Drug may cut diabetic cardiac deaths

Main Category: Hypertension
Article Date: 23 Aug 2003 - 0:00 PDT

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The incidence of sudden cardiac death among some diabetic patients could be cut using an angiotensin 2 receptor blocker instead of a beta blocker, according to Swedish research.

A study known as the Losartan Intervention For Endpoint reduction in hypertension (LIFE) conducted in March last year suggested that the angiotensin 2 receptor blocker losartan may offer better protection against sudden cardiac death than atenolol.

The LIFE study demonstrated a major reduction of all-cause mortality - particularly that relating to cardiovascular problems - in patients with diabetes and left ventricular hypertrophy when treated with losartan.

Now, in a post-hoc analysis of 1,195 participants in the LIFE study, 44 patients with diabetes, hypertension and left ventricular hypertrophy were found to have died of sudden cardiac death.

The researchers found that only 14 out of 586 deaths occurred in the losartan group, compared to 30 out of 609 patients taking the beta blocker atenolol.

These figures signify almost a 50 per cent reduction in sudden death in losartan-treated patients compared with those treated with atenolol, the researchers say.

Professor Lars Lindholm, who led the LIFE study and works at Umea University's department of public health and clinical medicine, said "The reduction in sudden cardiac death with losartan was only evident for diabetic patients.

"These results are, however, exploratory, and require confirmation," he warned

In an accompanying commentary Dr Wilbert Aronow from Westchester Medical Centre and New York Medical College, in the US, said both sets of analysis showed that losartan was more effective than atenolol in treating hypertensive diabetic patients with left ventricular hypertrophy.

"However, a large double-blind randomised trial is necessary to investigate whether losartan is better, similar, or worse than propranolol, timolol, metoprolol or carvedilol - all beta blockers - in reducing sudden cardiac death and coronary events," he said.

Source: The Lancet