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Angiotensin II receptor antagonists: the prototype losartan
1Kaiser Permanente, Wheat Ridge, CO 80033, USA.
The Annals of Pharmacotherapy
|June 1, 1996
Summary
Losartan, a new angiotensin II receptor antagonist, effectively lowers blood pressure with a favorable safety profile, offering an alternative to ACE inhibitors for hypertension management.
Area of Science:
- Pharmacology
- Cardiovascular Medicine
Background:
- Hypertension management.
- Angiotensin II receptor antagonists as a novel therapeutic class.
Purpose of the Study:
- To describe angiotensin II receptor antagonists, focusing on losartan.
- Review pharmacokinetic data, clinical trials, adverse reactions, drug interactions, and dosing.
Main Methods:
- MEDLINE search of English-language literature (1966-1995).
- Inclusion of manufacturer-provided data for losartan.
- Emphasis on human clinical and pharmacokinetic studies.
- Evaluation of controlled, double-blind studies for efficacy and safety.
Main Results:
- Losartan is a nonpeptide, competitive type I angiotensin II receptor antagonist.
- Antihypertensive efficacy comparable to angiotensin-converting enzyme (ACE) inhibitors.
- Well-tolerated with a placebo-like adverse effect profile and less cough than ACE inhibitors.
- Combination product (losartan/hydrochlorothiazide) approved for treatment-resistant hypertension.
- Investigational uses in ventricular hypertrophy, renal disease, and heart failure.
Conclusions:
- Losartan is an effective new antihypertensive agent with a placebo-like safety profile.
- An alternative for patients intolerant to ACE inhibitors.
- Further evaluation needed for mortality impact and role in other cardiovascular conditions.