HEMODYNAMIC AND HUMORAL EFFECTS OF THE ANGIOTENSIN-II ANTAGONIST LOSARTAN IN ESSENTIAL-HYPERTENSION

被引：70

作者：

GROSSMAN, E

PELEG, E

CARROLL, J

SHAMISS, A

ROSENTHAL, T

机构：

[1] Chorley Hypertension Unit, Chaim Sheba Medical Center, Tel Hashomer, Tel Aviv University Sackler School of Medicine, Tel Aviv

来源：

AMERICAN JOURNAL OF HYPERTENSION | 1994年 / 7卷 / 12期

关键词：

ANGIOTENSIN II ANTAGONIST; BLOOD PRESSURE; PLASMA RENIN ACTIVITY; ALDOSTERONE; NOREPINEPHRINE;

D O I：

10.1093/ajh/7.12.1041

中图分类号：

R6 [外科学];

学科分类号：

1002 ; 100210 ;

摘要：

Losartan (DuP 753) is a novel orally active angiotensin II antagonist that lowers blood pressure. The present study evaluates the hemodynamic and humoral effects of losartan in essential hypertension. Fifteen patients (12 men, 3 women; mean age, 46 +/- 2 years; range, 33 to 64 years) with a diastolic blood pressure (DBP) between 95 and 115 mm Hg after 2 weeks of placebo participated in the study. Initially the patients were treated with losartan (50 mg) once daily for 1 month. Then, if the trough DBP was greater than or equal to 93 mm Hg, hydrochlorothiazide (HCTZ), 6.25 to 12.5 mg daily, and nifedipine, 30 to 60 mg daily, were added as needed. Ten patients completed 12 months of treatment. Trough blood pressure, heart rate, plasma creatinine, potassium, uric acid, cholesterol, renin activity (PRA), aldosterone, and norepinephrine were measured at baseline and after 1 and 12 months of treatment. Losartan lowered mean arterial pressure significantly from 119 +/- 2 mm Hg at baseline to 113 +/- 2 mm Hg (P <.05) after 1 month of treatment. Coadministration of HCTZ and nifedipine further decreased the mean arterial pressure to 103 +/- 2 mm Hg after 12 months of treatment. Plasma levels of creatinine, potassium, uric acid, cholesterol, and norepinephrine remained unchanged. PRA increased and plasma aldosterone decreased significantly (P <.05). The decrease in mean arterial pressure was related to baseline PRA (r = 0.53, P <.05) and to the change in PRA (r = 0.52, P <.05). Our results indicate that losartan can be used safely as an antihypertensive agent, and that its efficacy is more prominent in patients with high renin hypertension.

引用

页码：1041 / 1044

页数：4

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