Comparison of New-Onset Heart Failure Between Losartan and Lisinopril in Patients with Hypertension

Abstract Background: Angiotensin-converting enzyme inhibitors and angiotensin-II receptor blockers are first-line agents in the management of hypertension and are known to have cardioprotective effects. Whether losartan is more effective a reducing the risk of new-onset heart failure (NOHF) compared to lisinopril is unexplored.

Methods

The Research Collaborative Network of the TriNetX platform was accessed to collect de-identified patient data to compare NOHF between patients with hypertension who were prescribed losartan or lisinopril during the period Jan 1, 2020 to Jul 1, 2026. Secondary outcomes included new-onset systolic HF, new-onset diastolic HF, and emergency department (ED) visits or hospital admissions. Clinically relevant covariates were controlled for using 1:1 propensity score matching. Cox regression analysis was used to calculate hazard ratios (HR) with 95% confidence intervals (CI).