The acute and chronic effects of losartan in heart failure.
BACKGROUND
Losartan is a novel, orally active, non-peptide angiotensin II receptor antagonist which specifically blocks the angiotensin II (AT1) receptor. It is postulated that losartan will have beneficial haemodynamic effects in heart failure similar to angiotensin converting enzyme inhibitors.


RESULTS
In patients with heart failure a single dose of losartan resulted in increased angiotensin II and decreased aldosterone levels. Systemic vascular resistance and systemic blood pressure were reduced. A 12-week study in similar patients found a persisting effect on systemic vascular resistance and systemic blood pressure after 12 weeks. Pulmonary capillary wedge pressure and heart rate were reduced and cardiac index increased after 12 weeks despite little acute effect on these parameters.


CONCLUSIONS
Losartan resulted in favourable and persisting haemodynamic effects in patients with heart failure. Further studies will be required to fully define the role of this drug in heart failure.
Crozier
I
I
Department of Cardiology, Christchurch Hospital, New Zealand.
Ikram
H
H
D000804:Angiotensin II / Q000097:blood; D047228:Angiotensin II Type 1 Receptor Blockers / Q000494:pharmacology / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects / Q000502:physiology; D018849:Controlled Clinical Trials as Topic; D004305:Dose-Response Relationship, Drug; D006333:Heart Failure / Q000097:blood / Q000188:drug therapy* / Q000503:physiopathology; D006339:Heart Rate / Q000187:drug effects / Q000502:physiology; D006801:Humans; D019808:Losartan / Q000494:pharmacology / Q000627:therapeutic use*; D011669:Pulmonary Wedge Pressure / Q000187:drug effects / Q000502:physiology; D012083:Renin / Q000097:blood; D016896:Treatment Outcome; D014655:Vascular Resistance / Q000187:drug effects / Q000502:physiology
D047228:Angiotensin II Type 1 Receptor Blockers; D000804:Angiotensin II; D012083:Renin; D019808:Losartan