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Efficacy of losartan and carvedilol on central hemodynamics in hypertensives: a prospective, randomized, open,

Eung Ju Kim1, Woo-Hyuk Song2, Jae Ung Lee3

  • 1Division of Cardiology, Department of Internal Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea.

Hypertension Research : Official Journal of the Japanese Society of Hypertension
|September 13, 2013
PubMed

Insights

Losartan and carvedilol, both blood pressure medications, showed similar effects on central hemodynamics and metabolic markers over 24 weeks. Losartan demonstrated a slightly better impact on aortic augmentation index.

Area of Science:

  • Cardiology
  • Pharmacology
  • Hypertension Research

Background:

  • Renin-angiotensin system (RAS) blockers show better clinical outcomes than atenolol, possibly due to central hemodynamic differences.
  • Limited comparative studies exist between RAS blockers and newer vasodilating beta-blockers.

Purpose of the Study:

  • To compare the central hemodynamic effects of losartan and carvedilol in hypertensive patients.
  • To evaluate the impact of these drugs on arterial stiffness, central blood pressure, and metabolic parameters.

Main Methods:

  • Prospective, randomized, open-label study with blinded endpoints.
  • 201 hypertensive patients enrolled; 182 analyzed after 24 weeks of losartan or carvedilol treatment.
  • Noninvasive measurements included carotid-femoral pulse wave velocity (cfPWV), aortic augmentation index (AIx), AIx@HR75, and central blood pressure.

Main Results:

  • No significant between-group differences in brachial blood pressure, cfPWV, AIx@HR75, or central blood pressure changes.
  • Losartan showed a more favorable effect on the aortic augmentation index (AIx).
  • Metabolic and inflammatory parameters, except for uric acid, showed no significant differences between groups.

Conclusions:

  • Losartan and carvedilol exhibit comparable effects on central hemodynamic indices, arterial stiffness, and metabolic profiles in hypertensive patients after 24 weeks.
  • Both treatments effectively manage peripheral blood pressure, with losartan offering a potential advantage in reducing central arterial pressure augmentation.

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