Effect of losartan on sudden cardiac death in people with diabetes: data from the LIFE study

Lancet. 2003 Aug 23;362(9384):619-20. doi: 10.1016/S0140-6736(03)14183-9.


In the Losartan Intervention For Endpoint reduction in hypertension (LIFE) study, a major reduction of all-cause mortality--especially cardiovascular mortality--in patients with diabetes with left ventricular hypertrophy was reported for treatment with losartan. We postulated post hoc that losartan might have a better effect on sudden cardiac death than atenolol, and we aimed to test this hypothesis. 44 patients with diabetes died of sudden cardiac death; significantly fewer deaths arose in the losartan group (14) than in the atenolol group (30; p=0.027). In the losartan group, five (6%) of 86 patients with diabetes and atrial fibrillation during the trial died of sudden cardiac death compared with nine (2%) of 500 in those without atrial fibrillation. The respective figures for the atenolol group were 14 (13%) of 105 and 16 (3%) of 504. Our results suggest losartan affords better protection against cardiac death from arrhythmias for patients with diabetes mellitus than does atenolol. Importantly, our analyses were exploratory and require confirmation.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Antihypertensive Agents / therapeutic use*
  • Arrhythmias, Cardiac / epidemiology
  • Arrhythmias, Cardiac / mortality*
  • Atenolol / therapeutic use
  • Atrial Fibrillation / epidemiology
  • Atrial Fibrillation / mortality
  • Comorbidity
  • Death, Sudden, Cardiac / epidemiology
  • Death, Sudden, Cardiac / prevention & control*
  • Diabetes Complications*
  • Diabetes Mellitus / epidemiology
  • Diabetes Mellitus / mortality
  • Female
  • Humans
  • Hypertension / drug therapy*
  • Hypertension / epidemiology
  • Hypertension / mortality
  • Hypertrophy, Left Ventricular / epidemiology
  • Hypertrophy, Left Ventricular / mortality
  • Losartan / therapeutic use*
  • Male


  • Antihypertensive Agents
  • Atenolol
  • Losartan