Abstract
In an open-label trial, 54 patients with hypertension (22 men and 32 women, aged 42 to 67 years [mean age, 54 ± 16 years]), who had discontinued therapy with calcium channel blockers (group 1, n = 15) or angiotensin-converting enzyme (ACE) inhibitors (group 2, n = 39) after 30 to 40 days because of peripheral edema or dry cough, respectively, were treated with losartan 50 mg/d orally for 30 days. Mean baseline values for sitting systolic and diastolic blood pressures and heart rate were 164.3 ± 4.9 mm Hg, 102.3 ± 5.4 mm Hg, and 67.0 ± 6.5 beats/min, respectively, in group 1, and 162.6 ± 7.9 mm Hg, 101.3 ± 4.6 mm Hg, and 68.2 ± 6.1 beats/min, respectively, in group 2. Losartan treatment was continued for 6 months, and all 54 patients completed the study. Losartan reduced blood pressure levels to 136.6 ± 10.8/85.0 ± 6.2 mm Hg in group 1 and 136.5 ± 8.9/80.6 ± 7.0 mm Hg in group 2 after 30 days of treatment, without evidence of changes in heart rate. The antihypertensive efficacy of losartan was similar to that observed at the end of the initial therapy with calcium channel blockers (138.3 ± 8.9/83.6 ± 5.1 mm Hg) or ACE inhibitors (136.7 ± 5.5/80.4 ± 7.8 mm Hg). Clinical side effects associated with losartan therapy were minimal, and hematologic and biochemical profiles were not altered by the drug. Only two patients exhibited mild dizziness, which disappeared during the trial. Results of this study indicate that losartan is an effective, well-tolerated drug for the treatment of essential hypertension, especially in patients with reduced tolerance to calcium channel blockers or ACE inhibitors.
Published Version
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