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Published on: September 17, 2015
Long-term effects of losartan on blood pressure and left ventricular structure in essential hypertension
A Himmelmann1, A Svensson, A Bergbrant
1Department of Medicine, Ostra University Hospital, Göteborg, Sweden.
Insights
Losartan effectively lowers blood pressure in patients with essential hypertension. Long-term use did not significantly alter left ventricular mass but increased left ventricular wall thickness.
Area of Science:
- Cardiology
- Pharmacology
Background:
- Essential hypertension is a common condition associated with cardiovascular risks.
- Left ventricular mass (LVM) is a key indicator of cardiac remodeling in hypertensive patients.
Purpose of the Study:
- To compare the effects of losartan and atenolol on blood pressure and left ventricular mass in patients with essential hypertension.
- To evaluate the long-term effects of losartan on left ventricular structure and blood pressure control.
Main Methods:
- A 12-week randomized, double-blind study comparing losartan and atenolol in 24 hypertensive patients.
- An open-label, extended follow-up period for 19 patients treated with losartan, with echocardiographic measurements of left ventricular structures.
Main Results:
- Both losartan and atenolol effectively reduced blood pressure (BP).
- Losartan showed a trend towards reducing LVM compared to atenolol during the initial phase.
- Long-term losartan treatment significantly reduced BP and LV internal diameter, but increased interventricular septal and posterior wall thickness, with no significant change in calculated LVM.
Conclusions:
- Losartan is effective for long-term blood pressure reduction in essential hypertension.
- While not significantly altering overall LVM, losartan treatment led to increased left ventricular wall thickness.
- Further research may be needed to fully elucidate the long-term cardiac remodeling effects of losartan.
Abstract:
In a 12-week, randomized, double-blind study, 24 patients with essential hypertension were given the angiotensin II antagonist losartan, or the beta-adrenoceptor blocker atenolol. Both drugs reduced blood pressure (BP) well, but losartan tended to reduce left ventricular mass (LVM) in contrast to atenolol. Following the double-blind phase 19 patients entered an open treatment period with losartan and additional treatment if BP was uncontrolled. LV structures were measured by echocardiography. The mean follow-up period was 29 +/- 2.6 (range 26-32) months. BP was reduced from 155.6 +/- 15.6/103.4 +/- 5.2 mm Hg to 131.3 +/- 10.5/82.7 +/- 3.3 mm Hg (P < 0.001). LV internal diameter was reduced (50.7 +/- 4.5 to 49.1 +/- 4.0 mm; P = 0.006), while there was an increase in interventricular septal thickness (10.2 +/- 1.1 to 11.2 +/- 1.3 mm; P = 0.001) and posterior wall thickness (10.0 +/- 0.9 to 10.6 +/- 1.1 mm; P = 0.023). Calculated LVM was not significantly altered during the follow-up period. In conclusion, losartan is effective in reducing BP during long-term treatment. No significant effect on LVM was observed, but there was an increase in LV wall thickness.
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