Cited by 174Heart Failure Treatment and ManagementBlood Pressure and Hypertension StudiesHeart rate and cardiovascular health

Efficacy and safety of high-dose lisinopril in chronic heart failure patients at high cardiovascular risk, including those with diabetes mellitus. Results from the ATLAS trial

RYDEN, L·2000·European Heart Journal

Abstract

AIMS: An analysis was designed to determine whether chronic heart failure patients at high cardiovascular risk benefited to the same extent from high-dose lisinopril as the whole ATLAS population. METHODS AND RESULTS: A retrospective analysis was performed on high-risk heart failure patients in the Assessment of Treatment with Lisinopril And Survival (ATLAS) trial (total number of patients 3164) comparing highdose (32.5-35 mg. day(-1)) vs low-dose (2.5-5 mg. day(-1)) lisinopril for a median of 46 months. These high-risk patients included those with hypotension, hyponatraemia, compromised renal function, the elderly and patients with diabetes mellitus at baseline. In the whole study population, high-dose lisinopril led to a trend in risk reduction of all-cause mortality (primary end-point P=0.128) and a significant risk reduction in all-cause mortality plus hospitalization (principal secondary end-point P=0.002). Subgroup analyses were performed for these end-points. There were no consistent interactions between age, baseline sodium, creatinine or potassium values, and treatment effect. Diabetics showed a beneficial response to high-dose therapy that was at least as good as that in non-diabetics. The underlying higher morbidity/mortality rates in diabetics mean that high-dose lisinopril has potential for a larger absolute clinical impact in these patients. CONCLUSION: Long-term high-dose lisinopril was as effective and well-tolerated in high-risk patients, including those with diabetes mellitus, as for the ATLAS study population as a whole.

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Registry

Crossref · 10.1053/euhj.2000.2311

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Authors
RYDEN, L.
Venue
European Heart Journal
Published
2000-12
Volume
21
Issue
23
Pages
1967-1978
ISSN
0195-668X (ISSN-L)
OpenAlex
W2109251059
Cited by
174
References
18
Citations by year
2025: 2 · 2024: 5 · 2023: 8 · 2022: 8 · 2021: 4 · 2020: 15 · 2019: 11 · 2018: 3 · 2017: 10 · 2016: 6 · 2015: 9 · 2014: 13 · 2013: 6 · 2012: 5
FWCI
4.02
Type
journal article
Language
en
Open access
closed
Locations
  • European Heart Journal (publishedVersion)
  • PubMed (publishedVersion)
  • Adelaide Research & Scholarship (AR&S) (University of Adelaide) (submittedVersion)
Topics
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Failure Treatment and Management
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart rate and cardiovascular health
Keywords
lisinopril, chronic heart failure, diabetes mellitus, ATLAS trial, all-cause mortality, hospitalization, subgroup analysis, drug safety, renin-angiotensin system blockade, elderly patients, renal dysfunction, hyponatremia
MeSH terms
Aged, Aged, 80 and over, Angiotensin-Converting Enzyme Inhibitors, Chronic Disease, Drug Administration Schedule, Female, Heart Failure, Hospitalization, Humans, Male, Middle Aged, New York, Retrospective Studies, Survival Analysis, Randomized Controlled Trials as Topic, Databases, Factual, Lisinopril, Diabetes Complications

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