Antihypertensive therapy in critical occupations: studies with an angiotensin II antagonist.
OBJECTIVE
This study was performed to establish whether an angiotensin II antagonist modulates daytime sleepiness or performance.


METHODS
The central effects of losartan (50 and 100 mg), as well as amlodipine (5 and 10 mg) and promethazine (10 mg), were studied in six healthy volunteers (aged between 20 and 27 (mean 24) yr). Digit symbol substitution, tracking, vigilance, immediate and short-term memory recall, complex reaction time, together with objective (daytime sleep latencies) and subjective measures of sleepiness, were measured 1.0 h before and 0.5, 2.0, 3.5, 5.0, 6.5, and 8.0 h after ingestion. The study was placebo-controlled and double-blind with a six-way crossover design.


RESULTS
No changes in performance or in measurements related to sleepiness were observed with losartan (50 and 100 mg). Amlodipine (10 mg) impaired immediate memory and increased subjective sleepiness at 8.0 h (p < 0.05). Promethazine (10 mg) impaired vigilance and immediate memory recall and increased reaction time (basic and complex) from 2.0 to 6.5 h after ingestion, impaired tracking from 3.5 to 6.5 h and increased subjective sleepiness from 2.0 to 8.0 h (p < 0.05).


CONCLUSIONS
The study suggests that an angiotensin II antagonist could prove useful for the treatment of hypertension in aircrew.
Nicholson
A N
AN
Centre for Human Sciences, Farnborough, Hants., UK.
Roberts
D P
DP
Stone
B M
BM
Turner
C
C
D000328:Adult; D000337:Aerospace Medicine; D000959:Antihypertensive Agents / Q000494:pharmacology* / Q000627:therapeutic use; D018592:Cross-Over Studies; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D019808:Losartan / Q000494:pharmacology* / Q000627:therapeutic use; D008297:Male; D008568:Memory; D011939:Mental Recall; D012890:Sleep / Q000187:drug effects; D013647:Task Performance and Analysis
D000959:Antihypertensive Agents; D019808:Losartan