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A decade ago, beta-blockers and diuretics were considered the most effective preventive drug therapies in hypertensive patients. Since then, blocking angiotensin-II has been shown to reverse left-ventricular hypertrophy (LVH). Might angiotensin-II-receptor blockers (ARBs), therefore, have clinical benefits that go beyond lowering blood pressure?
In this manufacturer-funded, double-blind trial, 9193 patients with hypertension and ECG signs of LVH were randomized to receive the ARB losartan or the beta-blocker atenolol (mean daily doses, 82 mg and 79 mg, respectively). More than half of both groups received concomitant hydrochlorothiazides, but no patients took ACE inhibitors, other ARBs, or other beta-blockers.
During follow-up (mean, 4.8 year…