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Clinicians continue to debate whether newer drugs should replace diuretics and β-blockers as first-line antihypertensive agents. In this international, randomized, double-blind trial, researchers compared the angiotensin-receptor-blocker losartan with the β-blocker atenolol in 9193 patients (age range, 55 to 80) with essential hypertension (160 to 200 mm Hg systolic, or 95 to 115 mm Hg diastolic); all patients had left ventricular hypertrophy, as determined by electrocardiography. When necessary, hydrochlorothiazide was given to patients in both groups to help achieve target blood pressures of 140/90 mm Hg. The study was sponsored by the maker of losartan.
During an average follow-up of almost 5 years, mean BP fell from about 174/98 mm Hg to…