Long-term central hemodynamic effects at rest and during exercise of losartan in essential hypertension.
BACKGROUND
Losartan reduces blood pressure in patients with essential hypertension, but the long-term central hemodynamic effects at rest and during exercise are not known.


RESULTS
After 8 months of losartan treatment (50 to 100 mg daily, mean 82 mg), intra-arterial pressure was reduced from 165/102 mm Hg to 145/91 mm Hg at rest and from 193/104 mm Hg to 179/96 mm Hg during 100 W exercise in 28 patients with essential hypertension. Cardiac index and heart rate remained unchanged, but total peripheral resistance index was reduced 12% to 15%. Stroke index was unchanged at rest but increased 7% to 9% during exercise. Twenty-four-hour ambulatory blood pressure was reduced 10% to 13%. Left ventricular mass was reduced 27% in patients with left ventricular hypertrophy (n = 18).


CONCLUSIONS
Losartan lowers blood pressure by reducing total peripheral resistance at rest and during exercise but cardiac pump function is unchanged or slightly improved. In patients with left ventricular hypertrophy, losartan induces a sizeable reduction in left ventricular mass.
Omvik
P
P
Institute of Internal Medicine, Department of Cardiology, Bergen, Norway. Per.Omvik@meda.uib.no
Gerdts
E
E
Myking
O L
OL
Lund-Johansen
P
P
D000328:Adult; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D018660:Blood Pressure Monitoring, Ambulatory; D002940:Circadian Rhythm / Q000502:physiology; D018618:Echocardiography, Doppler, Color; D015444:Exercise / Q000502:physiology*; D005260:Female; D005500:Follow-Up Studies; D006352:Heart Ventricles / Q000000981:diagnostic imaging; D006439:Hemodynamics / Q000187:drug effects / Q000502:physiology*; D006801:Humans; D006973:Hypertension / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000503:physiopathology*; D017379:Hypertrophy, Left Ventricular / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000517:prevention & control; D019808:Losartan / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012146:Rest / Q000502:physiology*; D012449:Safety
D000959:Antihypertensive Agents; D019808:Losartan