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Losartan in Cushing's syndrome
S Zacharieva1, M Orbetzova, E Natchev
1Clinical Center of Endocrinology and Gerontology, Medical University, Sofia, Bulgaria.
Summary
Losartan treatment in Cushing's syndrome patients lowered blood pressure by affecting the renin-angiotensin system. This study explored losartan's impact on active renin, plasma, and urinary kallikrein activity.
Area of Science:
- Endocrinology
- Cardiovascular Pharmacology
- Renal Physiology
Background:
- Cushing's syndrome is characterized by excess cortisol, leading to hypertension.
- The renin-angiotensin-aldosterone system (RAAS) plays a crucial role in blood pressure regulation.
- Kallikrein-kinin system interactions with RAAS in Cushing's syndrome are not fully understood.
Purpose of the Study:
- To investigate the effects of losartan, an angiotensin II receptor blocker, on blood pressure and hormonal markers in patients with Cushing's syndrome.
- To explore the relationship between the kallikrein system and the RAAS in this patient population.
Main Methods:
- Eleven patients with Cushing's syndrome participated.
- Standard sodium intake was maintained.
- A single oral dose of 50 mg losartan was administered for 3 days.
- Measurements included blood pressure, active renin, plasma kallikrein, and urinary kallikrein activity.
Main Results:
- Losartan treatment significantly decreased both systolic and diastolic blood pressure.
- Active renin levels were stimulated by losartan.
- Plasma and urinary kallikrein activity decreased following losartan administration.
- Blood pressure reduction was independent of baseline active renin levels.
Conclusions:
- Losartan effectively lowers blood pressure in patients with Cushing's syndrome.
- The drug influences the renin-angiotensin system and kallikrein activity.
- Further research is warranted to elucidate the complex interplay between the kallikrein and RAAS in Cushing's syndrome.