Effects of the angiotensin II antagonist losartan in hypertensive patients with renal disease.
OBJECTIVE
To study the effects of the angiotensin II antagonist losartan in hypertensive patients with renal disease.


METHODS
A single-blind longitudinal study was performed, lasting 4 months. Patients were treated once a day with placebo, 50 mg losartan, 100 mg losartan and placebo, each for 1 month, in sequence. Measurements were taken at the end of each treatment period.


METHODS
The study subjects comprised 13 patients with biopsy-proven renal disease, a diastolic blood pressure of > 90 mmHg, creatinine clearance of > 60 ml/min and stable proteinuria of > 2.0 g/day.


RESULTS
Mean arterial pressure, measured 4 h after the dose, fell from 113.8 +/- 2.1 mmHg (placebo) to 99.2 +/- 2.4 mmHg (50-mg dose) and 96.5 +/- 2.4 mmHg (100-mg dose). This blood pressure lowering effect was sustained for 24 h 116.3 +/- 2.3 mmHg (placebo) versus 105.5 +/- 1.8 mmHg (50-mg dose) and 103.3 +/- 1.9 mmHg (100-mg dose)]. The glomerular filtration rate remained stable, while the effective renal plasma flow increased by 12.5 +/- 2.9% (100-mg dose). The systemic and renal hemodynamic effects were similar at the 50- and 100-mg doses. Urinary excretion of total protein, albumin and immunoglobulin G decreased dose-dependently by a maximum of +/- 50% (100-mg dose). With the high dose, serum uric acid fell from 0.43 +/- 0.02 mmol/l to 0.39 +/- 0.02 mmol/l, and potassium increased from 4.2 +/- 0.1 to 4.6 +/- 0.1 mmol/l.


CONCLUSIONS
The angiotensin II antagonist losartan lowers blood pressure and displays a favorable renal profile in hypertensive patients with renal disease.
Gansevoort
R T
RT
Department of Medicine, State University Hospital, Groningen, The Netherlands.
de Zeeuw
D
D
Shahinfar
S
S
Redfield
A
A
de Jong
P E
PE
D000419:Albuminuria / Q000378:metabolism; D000804:Angiotensin II / Q000037:antagonists & inhibitors*; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001713:Biphenyl Compounds / Q000627:therapeutic use*; D001794:Blood Pressure; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D006977:Hypertension, Renal / Q000188:drug therapy* / Q000503:physiopathology; D007093:Imidazoles / Q000627:therapeutic use*; D008137:Longitudinal Studies; D019808:Losartan; D008297:Male; D011507:Proteinuria / Q000378:metabolism; D012079:Renal Circulation; D016037:Single-Blind Method; D013777:Tetrazoles / Q000627:therapeutic use*; D014527:Uric Acid / Q000097:blood
D000959:Antihypertensive Agents; D001713:Biphenyl Compounds; D007093:Imidazoles; D013777:Tetrazoles; D000804:Angiotensin II; D014527:Uric Acid; D019808:Losartan