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Effect of losartan and hydrochlorothiazide on exercise tolerance in exertional hypertension and left ventricular

William C Little1, Michael R Zile, Allan Klein

  • 1Cardiology Section, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA. wlittle@wfubmc.edu

The American Journal of Cardiology
|July 25, 2006
PubMed

Insights

Losartan and hydrochlorothiazide (HCTZ) both reduced exercise systolic blood pressure in patients with diastolic dysfunction. However, only losartan improved exercise tolerance and quality of life.

Area of Science:

  • Cardiology
  • Pharmacology

Background:

  • Left ventricular diastolic dysfunction is characterized by impaired relaxation and filling of the left ventricle.
  • Hypertensive response to exercise, defined as elevated systolic blood pressure during physical activity, is a significant clinical finding.

Purpose of the Study:

  • To compare the efficacy of losartan versus hydrochlorothiazide (HCTZ) in managing exercise-induced hypertension in patients with diastolic dysfunction.
  • To assess the impact of these treatments on exercise capacity and quality of life.

Main Methods:

  • A randomized, double-blind study involving 40 subjects with specific criteria for diastolic dysfunction and exercise systolic blood pressure.
  • Participants received either losartan 50 mg or HCTZ 12.5 mg daily for six months.
  • Evaluations included resting and exercise blood pressure, treadmill exercise time, quality of life scores, and oxygen consumption.

Main Results:

  • Both losartan and HCTZ effectively reduced exercise systolic blood pressure.
  • Losartan significantly increased treadmill exercise time and improved quality of life without altering oxygen consumption.
  • HCTZ did not significantly change exercise time or quality of life and led to a decrease in oxygen consumption.

Conclusions:

  • In patients with diastolic dysfunction and hypertensive response to exercise, both losartan and HCTZ can blunt exercise systolic blood pressure.
  • Losartan demonstrates superior benefits by enhancing exercise tolerance and improving quality of life compared to HCTZ in this patient population.

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