title: Effect of losartan in treatment of exercise-induced myocardial ischemia.
abstract: Because no controlled clinical studies are available about the possible role of angiotensin II receptor blockers in preventing effort myocardial ischemia, we evaluated the effect of angiotensin II receptor blocker/losartan in preventing exercise-induced myocardial ischemia in patients with coronary artery disease. Twenty-four sedentary patients with chronic stable ischemia were prospectively randomized to 28 days (double blind) of losartan 100 mg or losartan placebo in 2 divided doses. In each patient the treatment was crossed over to the alternative regimen (28 days, double blind) after a 1-week placebo period (single blind). At the end of each phase a new exercise stress test was performed. At baseline, systolic blood pressure was significantly decreased after losartan 100 mg compared with losartan placebo. At submaximal exercise, systolic blood pressure and rate-pressure product were lower after losartan 100 mg administration compared with losartan placebo, and these findings remained significant at 1-mm ST depression and at peak exercise. Losartan 100 mg administration versus losartan placebo significantly delayed the time to 1-mm ST-depression onset and decreased ST-segment depression at peak exercise and time to recovery of ST-segment depression. Losartan 100 mg administration compared with losartan placebo was able to significantly increase exercise duration and maximal workload during exercise stress testing. In conclusion, in our study, losartan decreased electrocardiographic parameters of myocardial ischemia in patients with coronary artery disease, suggesting a possible role of this drug in treatment of patients with effort myocardial ischemia.
authors.affiliation: Cardiology Division, Fondazione Salvatore Maugeri, IRCCS, Scientific Institute of Telese Terme, Telese Terme, Italy. glongobardi@fsm.it
authors.forename: Giancarlo
authors.initials: G
authors.lastname: Longobardi
authors.forename: Graziamaria
authors.initials: G
authors.lastname: Corbi
authors.forename: Francesco
authors.initials: F
authors.lastname: Cacciatore
authors.forename: Pasquale
authors.initials: P
authors.lastname: Abete
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Furgi
authors.forename: Dino Franco
authors.initials: DF
authors.lastname: Vitale
authors.forename: Franco
authors.initials: F
authors.lastname: Rengo
authors.forename: Nicola
authors.initials: N
authors.lastname: Ferrara
mesh_terms: D047228:Angiotensin II Type 1 Receptor Blockers / Q000627:therapeutic use*; D001794:Blood Pressure / Q000502:physiology; D003324:Coronary Artery Disease / Q000503:physiopathology*; D018592:Cross-Over Studies; D004311:Double-Blind Method; D004562:Electrocardiography; D005080:Exercise Test; D005260:Female; D006801:Humans; D019808:Losartan / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control*; D011446:Prospective Studies; D013599:Systole / Q000502:physiology
chemical_list: D047228:Angiotensin II Type 1 Receptor Blockers; D019808:Losartan