Edited by: Nadia S. Halim
B. Pitt, R. Segal, F.A. Martinez, G. Meurers, A.J. Cowley, I. Thomas, P.C. Deedwania, D.E. Ney, D.B. Snavely, P.I. Chang, "Randomised trial of losartan versus captopril in patients over 65 with heart failure (Evaluation of Losartan in the Elderly Study, ELITE)," The Lancet, 349:747-52, 1997. (Cited in more than 230 papers since publication)

Comments by Bertram Pitt, professor of medicine, division of cardiology, University of Michigan, Ann Arbor, and Robert Segal, director of cardiovascular clinical research, Merck Research Laboratories, West Point, Pa.

The Evaluation of Losartan in the Elderly (ELITE) study demonstrates how an unexpected finding generates research. ELITE started out as a safety and clinical outcome study comparing an angiotensin II receptor antagonist (AIIA), losartan, with an angiotensin-converting enzyme (ACE) inhibitor, captopril, in patients with heart failure. "We were all surprised to see a striking mortality benefit with losartan," says...

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