Change search
ReferencesLink to record
Permanent link

Direct link
Are coronary revascularization and myocardial infarction a homogeneous combined endpoint in hypertension trials? The Losartan intervention for endpoint reduction in hypertension study
Show others and affiliations
2010 (English)In: Journal of Hypertension, ISSN 0263-6352, E-ISSN 1473-5598, Vol. 28, no 6, 1134-1140 p.Article in journal (Refereed) Published
Abstract [en]

Objective: Construction of prognostically relevant endpoints for clinical trials in hypertension has increasingly included coronary revascularization with myocardial infarction (MI) as manifestations of coronary artery disease. However, whether coronary revascularization and MI predict other cardiovascular events similarly is unknown.


Methods: We examined risks of cardiovascular death, all-cause death, and stroke following MI or coronary revascularization in hypertensive patients with left ventricular hypertrophy (LVH) enrolled in the Losartan Intervention For Endpoint reduction in hypertension study (LIFE). We studied 9113 patients after excluding those who died within 7 days after MI or underwent coronary revascularization within 24 h after MI.


Results: In multivariate Cox regression adjusting for participating countries, time-varying systolic blood pressure, and Framingham risk score, hazard ratios for cardiovascular death, all-cause death, and stroke were, respectively, 4.5 (P < 0.0001), 2.9 (P < 0.0001), and 1.9 (P = 0.003) in 321 patients with MI as first event. In similar models, coronary revascularization as first event (n = 202) was not associated with increased risks of cardiovascular death, all-cause death, and stroke (P = 0.06–0.86).


Conclusion: During follow-up of hypertensive patients with LVH, occurrence of MI but not coronary revascularization as first cardiovascular event significantly increased risk of subsequent cardiovascular death, all-cause death, and stroke. In view of differences in prognostic implications, when the goal is to have a prognostically relevant composite endpoint for trials in hypertensive patients, caution should be used in combining coronary revascularization with MI.

Place, publisher, year, edition, pages
2010. Vol. 28, no 6, 1134-1140 p.
Keyword [en]
all-cause death, cardiovascular death, clinical trial, coronary revascularization, endpoint, myocardial infarction, stroke
URN: urn:nbn:se:umu:diva-42374DOI: 10.1097/HJH.0b013e328337a9c8ISI: 000277623500006OAI: diva2:409149
Available from: 2011-04-07 Created: 2011-04-07 Last updated: 2011-04-07Bibliographically approved

Open Access in DiVA

No full text

Other links

Publisher's full text

Search in DiVA

By author/editor
Lindholm, Lars H
By organisation
Family Medicine
In the same journal
Journal of Hypertension

Search outside of DiVA

GoogleGoogle Scholar
The number of downloads is the sum of all downloads of full texts. It may include eg previous versions that are now no longer available

Altmetric score

Total: 29 hits
ReferencesLink to record
Permanent link

Direct link