OBJECTIVES: In the LIFE study, losartan-based antihypertensive therapy reduced the primary composite endpoint of cardiovascular death, myocardial infarction, or stroke by 13% (p=0.02) and reduced the risk of stroke by 25% (p=0.001), despite comparable degree of blood pressure control in hypertensive patients with left ventricular hypertension (LVH) over 5.5 years. The objective of this study was to estimate LIFE target population (55-80 years, Diastolic BP /Systolic BP: 95 – 115/ 160-200 mmHg, ECG-LVH without heart failure or angina pectoris) and to project the reduction in stroke observed with losartan versus atenolol-based therapy in the LIFE study in France. METHODS: The population aged 55-80 was extracted from national statistics. Prevalence of hypertension was estimated by extrapolating the WHO MONICA data (Lille, Strasbourg, Toulouse) to this segment of the population. The number of patients with congestive heart failure and/or angina pectoris calculated from Thales (computerized data base) was substracted. Prevalence of LVH was based on the LIFE pilot study results. Number of strokes averted was estimated by multiplying the number of patients meeting LIFE inclusion criteria by the cumulative incidence risk difference in stroke from LIFE at 5.5 years. RESULTS: The French population aged 55-80 is comprised of 13 million people. Half are hypertensive. We conservatively projected that 1.4 million individuals meet LIFE study criteria. Using losartan based therapy in this target population, the projected cumulative number of strokes over 5.5 years would be 67,957, compared to 90,147 with atenolol, a difference of stroke averted of 22,190. CONCLUSIONS: The reduction with a losartan-based vs. atenolol-based regimen should be viewed as representing an incremental improvement relative to the benefit of conventional antihypertensives therapies, betablockers and diuretics. A population wide prevention of using losartan in hypertensive patients with LVH has the potential to have a major public health impact by reducing stroke incidence in France.