Central and peripheral hemodynamic effects of losartan and in combination with hydrochlorothiazide in mild to moderate essential hypertension.
BACKGROUND
Angiotensin II antagonists have proved to be effective antihypertensive agents with organoprotective properties. We aimed to clarify the effects of losartan and its combination with hydrochlorothiazide on 24-h blood pressures (BPs), central hemodynamics and microcirculation in essential hypertension (EH).


METHODS
Forty patients with mild to moderate EH were randomly allocated to receive losartan 50 mg (group I) or losartan 50 mg in combination with hydrochlorothiazide, 12.5 mg (group II). At baseline, week 2 and 8, ambulatory BP monitoring (ABPM), central hemodynamics monitoring and microcirculation investigation were performed.


RESULTS
In both groups, 24-h, daytime and night-time systolic (SBP) and diastolic (SBP) significantly decreased at week 8. DBP decreased more than SBP. Both drug regimens led to significant decrease in total peripheral vascular resistance; stroke and cardiac indexes remained unchanged. Losartan and its combination with hydrochlorothiazide improved main parameters of microcirculation. The index of microcirculation increased, as did the amplitude of cardiodependent and low frequency waves.


CONCLUSIONS
Losartan monotherapy and losartan in combination with hydrochlorothiazide are effective antihypertensive agents. The BP-lowering effect is realized through reduction of total peripheral vascular resistance. Moreover, both drug regimens significantly improve parameters of microcirculation.
Clinic of Internal Diseases, Sechenov Moscow Medical Academy, Moscow, Russia.
Valery I
VI
Podzolkov
Vladimir A
VA
Bulatov
Elena A
EA
Son
Ingrid
I
Os
D000328:Adult; D000704:Analysis of Variance; D001794:Blood Pressure / Q000187:drug effects; D018660:Blood Pressure Monitoring, Ambulatory; D002302:Cardiac Output / Q000187:drug effects; D002985:Clinical Protocols; D004359:Drug Therapy, Combination; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006439:Hemodynamics / Q000187:drug effects*; D006801:Humans; D006852:Hydrochlorothiazide / Q000627:therapeutic use*; D006973:Hypertension / Q000188:drug therapy*; D019808:Losartan / Q000627:therapeutic use*; D008297:Male; D008833:Microcirculation / Q000187:drug effects; D008875:Middle Aged; D009031:Moscow; D018579:Patient Selection; D018401:Sample Size; D013997:Time Factors; D016896:Treatment Outcome; D014655:Vascular Resistance / Q000187:drug effects
D006852:Hydrochlorothiazide; D019808:Losartan