When ACE inhibitors are used to lower blood pressure to the same degree as β-adrenoceptor antagonists or calcium channel blockers, ACE inhibitors do not seem to have additional benefits to these agents. In the Losartan Intervention for End Point Reduction in Hypertension study (LIFE), losartan was compared to atenolol in hypertensives with the additional risk factor of left ventricular hypertrophy (LVH). For similar effects on blood pressure, losartan had a greater benefit on the primary composite end point (cardiovascular mortality, stroke and myocardial infarction) than atenolol in the hypertensives with LVH, including a prespecified subgroup of patients with additional diabetes mellitus. Losartan also had a greater ability to reverse LVH than atenolol. Thus, losartan should become the standard treatment for hypertension when LVH is present.