Effects of losartan on hypertension and left ventricular mass: a long-term study (original) (raw)
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Current Therapeutic Research, 1998
The aim of this study was to assess the effects of losartan potassium, an angiotensin II receptor antagonist, on systolic blood pressure; diastolic blood pressure; and left ventricular dimensions, functions, and mass index (LVMI) in patients with mild-to-moderate essential hypertension. Twenty patients aged 40 to 65 years with either uncontrolled or previously untreated hypertension and echocardiographically documented left ventricniar hyptertrophy (LVH) defined by LVMI >130 g/m 2 for men and >110 g/m 2 for women were included in the study. Blood pressure measurements were taken at 2-week intervals. Blood samples were taken before treatment and after 3 months of treatment for determination of lipid concentrations and other laboratory variables used to monitor safety, and two-dimensional M-mode and Doppler echocardiographic measurements were obtained. Losartan was associated with a statistically significant reduction of mean systolic blood pressure from 173 ± 6 mm Hg to 135 ± 10 mm Hg and diastolic blood pressure from 100 ± 4 nun Hg to 82 ± 7 mm Hg without a change in heart rate. Significant decreases were identified in interventricuiar septal and left ventricular posterior wall thicknesses (from 12.5 ± 0.8 mm to 11.5 ± 0.8 mm and 12.1 ± 1.0 mm to 11.1 ± 0.8 mm, respectively). LVMI decreased from 138.8 ± 18.7 g/m 2 to 126.0 ± 21.8 g/m 2 after 3 months of treatment. Left ventricular dimensions and ejection fraction did not change significantly compared with baseline values. The Doppler echocardiographic assessment of mitral E/A ratio, which is a marker of diastolic function, increased significantly from baseline. Except for a significant increase in mean serum lactate dehydrogenase activity, laboratory findings (including serum lipid concentrations) remnined constant. No clinical adverse effects attributable to losartan were observed. Results of this study suggest that losartan is an effective, well-tolerated drug that reduces LVH, improves left ventriculur diastolic functions, and controls systolic and diastolic blood pressures in patients with mild-to-moderate essential hypertension.
Asian Journal of Pharmaceutical and Clinical Research
Objective: Hypertension is an important worldwide public health challenge because of its high frequency and concomitant risks of cardiovascular and kidney diseases. Left ventricular hypertrophy (LVH) is defined as an increase in the mass of the LV, which can be secondary to an increase in wall thickness, an increase in cavity size, or both. Relevant study reported that LVH is one of the major and independent risk factors for coronary artery disease, heart failure, serious dysrhythmias, and sudden death. Thus, regression of LVH is a primary pharmacologic objective. The objective of this study is to assess the effectiveness of losartan and amlodipine in regression of LVH and to monitor the adverse effects of these drugs on monotherapy. The study also focused to estimate the clinical effectiveness of specified drugs in lowering hypertension.Methods: The study conducted was retrospective, prospective, comparative study extended over 1 year on 28 patients based on inclusion and exclusion...
Current Therapeutic Research, 1997
In an open-label trial, 64 patients with hypertension (22 men and 32 women, aged 42 to 67 years [mean age, 54 * 16 years]), who had discontinued therapy with calcium channel blockers (group 1, n = 16) or angiotensin-converting enzyme (ACE) inhibitors (group 2, n = 39) after 30 to 40 days because of peripheral edema or dry cough, respectively, were treated with losartan 60 mg/d orally for 30 days. Mean baseline values for sitting systolic and diastolic blood pressures and heart rate were 164.3 * 4.9 mm Hg, 102.3 * 5.4 mm IIg, and 67.0 * 6.6 beats/m& respectively, in group 1, and 162.6 t 7.9 mm Hg, 101.3 * 4.6 mm IIg, and 68.2 * 6.1 beats/m& respectively, in group 2. Losartan treatment was continued for 6 months, and all 54 patients completed the study. Losartan reduced blood pressure levels to 136.6 t lO.Wl5.0 2 6.2 mm IIg in group 1 and 136.6 * 8.9180.6 t 7.0 mm Hg in group 2 after 30 days of treatment, without evidence of changes in heart rate. The antihypertensive efllcacy of losartan was similar to that observed at the end of the initial therapy with calcium channel blockers (138.3 * 8.9Rl3.6 * 5.1 mm Hg) or ACE inhibitors (136.7 * 5.W80.4 * 7.8 mm Hg). Clinical side effects aasociated with losartan therapy were minimal and hematologic and biochemical profiles were not altered by the drug. Only two patients exhibited mild dizziness, which disappeared during the trial. Results of this study indicate that losartan is an effective, well-tolerated drug for the treatment of essential hypertension, especially in patients with reduced tolerance to calcium channel blockers or ACE inhibitors.
Effects of Losartan in Women With Hypertension and Left Ventricular Hypertrophy
Hypertension, 2008
Hypertension is a risk factor for cardiovascular disease and outcomes in women. These posthoc analyses from the Losartan Intervention For Endpoint reduction in hypertension (LIFE) study evaluated losartan- versus atenolol-based therapy on the primary composite end point of cardiovascular death, stroke, and myocardial infarction and other end points in 4963 women. Fewer events occurred in women versus men. Women in the losartan group had significant reductions in the primary end point (215 [18.2 per 1000 patient-years] versus 261 [22.5 per 1000 patient-years]; hazard ratio [HR]: 0.82 [95% CI: 0.68 to 0.98]; P =0.031), stroke (109 versus 154; HR: 0.71 [95% CI: 0.55 to 0.90]; P =0.005), total mortality (HR: 0.77 [95% CI: 0.63 to 0.95]; P =0.014), and new-onset diabetes (HR: 0.75 [95% CI: 0.59 to 0.94]; P =0.015) versus the atenolol group, with no between-treatment difference for myocardial infarction (HR: 1.02 [95% CI: 0.74 to 1.39]; P =0.925), cardiovascular mortality (HR: 0.86 [95% C...
Effect of Losartan on Different Biochemical Parameters in Essential Hypertensive Patients
Biomedical and Pharmacology Journal, 2019
The renin–angiotensin system (RAS) provides the most powerful regulation of blood pressure and angiotensin II is the primary mediator in this system. The binding of angiotensin II to AT1 receptors produces a number of potentially harmful effects that include increase in blood pressure, progression of atherosclerosis, myocardial and vascular hypertrophy. Losartan was the first ARB and found to reduce the risk of stroke, new onset of diabetes and to have a proven benefit in stroke. The present study was designed to evaluate the effect of losartan on different biochemical parameters viz; blood sugar, lipid profile, uric acid and serum electrolytes. 29 newly diagnosed patients of either gender with essential hypertension were included in the study. Baseline readings of lipid profile, serum electrolytes, fasting blood sugar and uric acid were recorded before starting losartan monotherapy and were repeated after six months. After comparing the means, it was revealed that there was a signi...
American journal of hypertension, 1998
The primary objectives of this double-blind study were to compare the antihypertensive efficacy and tolerability of irbesartan and losartan, two angiotensin II (AT1 subtype) receptor antagonists with different pharmacokinetic profiles in patients with mild-to-moderate hypertension. Both drugs are approved for once-daily use (although losartan may also be prescribed twice-daily). After a placebo lead-in, 567 patients were randomized (1:1:1:1) to once-daily therapy with placebo, 100 mg losartan, 150 mg irbesartan, or 300 mg irbesartan for 8 weeks. Treatment groups had comparable demographic and baseline characteristics. After 8 weeks of treatment, reductions from baseline in trough seated diastolic blood pressure (SeDBP) and trough seated systolic blood pressure (SeSBP) with 300 mg irbesartan were greater than with 100 mg losartan (P < .01 for both comparisons), by 3.0 and 5.1 mm Hg, respectively; larger reductions were also demonstrated at weeks 1 and 4 (P < .01 and P = .017, r...
JAMA, 2002
Drug intervention in placebo-controlled trials has been beneficial in isolated systolic hypertension. To test the hypothesis that losartan improves outcome better than atenolol in patients with isolated systolic hypertension and electrocardiographically documented left ventricular hypertrophy (ECG-LVH). Double-blind, randomized, parallel-group study conducted in 1995-2001. A total of 1326 men and women aged 55 through 80 years (mean, 70 years) with systolic blood pressure of 160 to 200 mm Hg and diastolic blood pressure of less than 90 mm Hg (mean, 174/83 mm Hg) and ECG-LVH, recruited from 945 outpatient settings in the Nordic countries, the United Kingdom, and the United States. Patients were randomly assigned to receive once-daily losartan (n = 660) or atenolol (n = 666) with hydrochlorothiazide as the second agent in both arms, for a mean of 4.7 years. Composite end point of cardiovascular death, stroke, or myocardial infarction. Blood pressure was reduced by 28/9 and 28/9 mm Hg ...