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Long-term central hemodynamic effects at rest and during exercise of losartan in essential hypertension
P Omvik1, E Gerdts, O L Myking
1Institute of Internal Medicine, Department of Cardiology, Bergen, Norway. Per.Omvik@meda.uib.no
Insights
Losartan effectively lowers blood pressure in essential hypertension by reducing total peripheral resistance during rest and exercise. Cardiac function remains stable or improves, with significant left ventricular mass reduction in applicable patients.
Area of Science:
- Cardiology
- Pharmacology
- Hypertension Research
Background:
- Essential hypertension management often involves blood pressure reduction.
- Long-term effects of losartan on central hemodynamics during rest and exercise remain unclear.
Purpose of the Study:
- To investigate the long-term central hemodynamic effects of losartan in patients with essential hypertension.
- To assess the impact of losartan on blood pressure, cardiac function, and left ventricular mass.
Main Methods:
- A study involving 28 patients with essential hypertension treated with losartan (50-100 mg daily) for 8 months.
- Intra-arterial pressure, cardiac index, heart rate, total peripheral resistance index, and stroke index were measured at rest and during 100 W exercise.
- Twenty-four-hour ambulatory blood pressure and left ventricular mass were also assessed.
Main Results:
- Losartan reduced resting blood pressure (165/102 to 145/91 mm Hg) and exercise blood pressure (193/104 to 179/96 mm Hg).
- Total peripheral resistance index decreased by 12-15%, while cardiac index and heart rate remained unchanged.
- Stroke index increased during exercise, and left ventricular mass decreased by 27% in patients with left ventricular hypertrophy.
Conclusions:
- Losartan effectively lowers blood pressure by reducing total peripheral resistance at rest and during exercise.
- Cardiac pump function is maintained or slightly improved with losartan treatment.
- Losartan significantly reduces left ventricular mass in hypertensive patients with left ventricular hypertrophy.
Background:
Losartan reduces blood pressure in patients with essential hypertension, but the long-term central hemodynamic effects at rest and during exercise are not known.
Methods And Results:
After 8 months of losartan treatment (50 to 100 mg daily, mean 82 mg), intra-arterial pressure was reduced from 165/102 mm Hg to 145/91 mm Hg at rest and from 193/104 mm Hg to 179/96 mm Hg during 100 W exercise in 28 patients with essential hypertension. Cardiac index and heart rate remained unchanged, but total peripheral resistance index was reduced 12% to 15%. Stroke index was unchanged at rest but increased 7% to 9% during exercise. Twenty-four-hour ambulatory blood pressure was reduced 10% to 13%. Left ventricular mass was reduced 27% in patients with left ventricular hypertrophy (n = 18).
Conclusion:
Losartan lowers blood pressure by reducing total peripheral resistance at rest and during exercise but cardiac pump function is unchanged or slightly improved. In patients with left ventricular hypertrophy, losartan induces a sizeable reduction in left ventricular mass.
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