title: Effects of a combination of losartan and hydrochlorothiazide in patients with hypertension and a history of heart failure.
abstract: OBJECTIVE
  To evaluate the switching from an angiotensin receptor blocker (ARB) to a drug combination containing an ARB and a diuretic drug in terms of effects on hypertension, cardiac load, and cardiac function.
  
  
  METHODS
  In a study conducted on 82 patients with a history of heart failure and hypertension who had been treated with an ARB but failed to reach the target blood pressure, ongoing oral ARB treatment was switched to a drug combination of losartan and hydrochlorothiazide (HCTZ). Using ambulatory blood pressure monitoring (ABPM), the variations in blood pressure and the effects on cardiac load and cardiac function were evaluated before and after treatment.
  
  
  RESULTS
  Comparison of the ABPM findings before and after switching treatment showed significant improvements in mean systolic and diastolic blood pressure, improvements in systolic and diastolic blood pressure 1 hour before getting out of bed, and improvements in the plasma levels of human brain natriuretic peptide as an indicator of cardiac load.
  
  
  CONCLUSIONS
  The drug combination of losartan and hydrochlorothiazide showed a stronger antihypertensive effect than that of the conventional ARB and improved heart function.
authors.affiliation: Department of Cardiology, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa 259-1193, Japan. kanchi@is.icc.u-tokai.ac.jp.
authors.forename: Shigetaka
authors.initials: S
authors.lastname: Kanda
authors.forename: Koichiro
authors.initials: K
authors.lastname: Yoshioka
authors.forename: Mari
authors.initials: M
authors.lastname: Amino
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Deguchi
authors.forename: Toru
authors.initials: T
authors.lastname: Aizawa
authors.forename: Teruhisa
authors.initials: T
authors.lastname: Tanabe
authors.forename: Yuji
authors.initials: Y
authors.lastname: Ikari
mesh_terms: D000368:Aged; D047228:Angiotensin II Type 1 Receptor Blockers / Q000627:therapeutic use*; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D015415:Biomarkers / Q000097:blood; D001794:Blood Pressure; D004232:Diuretics / Q000627:therapeutic use*; D057915:Drug Substitution; D004359:Drug Therapy, Combination; D005260:Female; D006333:Heart Failure / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology; D006334:Heart Function Tests; D006801:Humans; D006852:Hydrochlorothiazide / Q000627:therapeutic use*; D006973:Hypertension / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology; D019808:Losartan / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood; D010349:Patient Compliance; D016896:Treatment Outcome
chemical_list: D047228:Angiotensin II Type 1 Receptor Blockers; D000959:Antihypertensive Agents; D015415:Biomarkers; D004232:Diuretics; D006852:Hydrochlorothiazide; D020097:Natriuretic Peptide, Brain; D019808:Losartan