Adding losartan to maximally tolerated ACE inhibition in heart failure patients safely reduced systolic blood pressure from 122 to 107 mm Hg (p<0.001).
Observational (n=43)
Does adding losartan to maximally tolerated ACE inhibitors safely reduce blood pressure in patients with symptomatic congestive heart failure?
Adding losartan to maximal ACE inhibitor therapy safely reduces blood pressure and provides further vasodilation in patients with symptomatic heart failure.
Absolute Event Rate: 107% vs 122%
p-value: p=<0.001
Combined therapy with an angiotensin-II type I receptor (AT1) antagonist and an angiotensin-converting enzyme (ACE) inhibitor results in more complete suppression of the renin-angiotensin system. Accordingly, the blood-pressure response and safety of combining AT1-receptor blockade with losartan for ACE inhibition were evaluated in patients with congestive heart failure who were already treated with maximally recommended or tolerated doses of an ACE inhibitor. Forty-three patients with symptomatic congestive heart failure were evaluated biweekly for 1 month before addition of losartan and weekly during administration of losartan at a daily dose of 25 mg for the first week and 50 mg for the second week. Systolic blood pressure, which remained unchanged before addition of losartan, decreased from 122 +/- 18 mm Hg to 112 +/- 17 and 107 +/- 17 mm Hg (p < 0.001) after 1 week of 25 mg and 1 week of 50 mg losartan, respectively. Diastolic blood pressure also significantly decreased. The decreases in blood pressure were well tolerated by all patients, even by those in whom symptomatic hypotension developed during uptitration of ACE inhibition. Serum potassium and sodium and parameters of renal function remained unchanged. Combining AT1-receptor blockade with losartan to maximally recommended or tolerated ACE inhibition appears safe and leads to further vasodilatation in symptomatic patients with congestive heart failure.
Hamroff et al. (Wed,) conducted a observational in Congestive heart failure (n=43). Losartan vs. Baseline (ACE inhibitor alone) was evaluated on Systolic blood pressure (p=<0.001). Adding losartan to maximally tolerated ACE inhibition in heart failure patients safely reduced systolic blood pressure from 122 to 107 mm Hg (p<0.001).