Abstract | BACKGROUND & AIMS: METHODS: Twenty-seven compensated patients were randomized to receive losartan 25 mg/day (n = 17) or propranolol (n = 10). Hepatic venous pressure gradient (HVPG), portal blood flow (Doppler duplex ultrasound) and systemic hemodynamics were measured at baseline and after 12-week treatment. Portal resistance was calculated as HVPG/portal blood flow. RESULTS:
Propranolol induced a reduction in cardiac output (p 0.002), heart rate (p 0.0001) and HVPG [from 16.4 (+/- 4.1) to 13.1 (+/- 3.6) mmHg (p 0.07)]; six patients showed a reduction equal or greater than 20% and were considered responders. Losartan caused a decrease in HVPG [from 15.6 (+/- 4.2) to 11.8 (+/- 3.5) mmHg (p 0.002)], without changes in portal blood flow and systemic hemodynamics. Changes in HVPG correlated with variations in portal resistance (r 0.88, p < 0.0001). Losartan induced a reduction in HVPG between 10 and 19% in 5/17 patients, and 20% or more in 8/17. Five out of eight patients who respond to losartan showed severe portal hypertension, with higher baseline HVPG (equal or greater than 16 mmHg). CONCLUSIONS: the administration of losartan in a doses of 25 mg per day may be effective in lowering portal pressure in patients with compensated cirrhosis, particularly in those with more severe portal hypertension.
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Authors | Gustavo Castaño, Pedro Viudez, Miguel Riccitelli, Silvia Sookoian |
Journal | Annals of hepatology
(Ann Hepatol)
2003 Jan-Mar
Vol. 2
Issue 1
Pg. 36-40
ISSN: 1665-2681 [Print] Mexico |
PMID | 15094704
(Publication Type: Clinical Trial, Journal Article, Randomized Controlled Trial)
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Chemical References |
- Antihypertensive Agents
- Propranolol
- Losartan
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Topics |
- Adult
- Aged
- Antihypertensive Agents
(therapeutic use)
- Female
- Hemodynamics
(drug effects)
- Humans
- Hypertension, Portal
(diagnostic imaging, drug therapy, etiology, physiopathology)
- Liver Cirrhosis
(complications, drug therapy, physiopathology)
- Losartan
(therapeutic use)
- Male
- Middle Aged
- Portal Vein
(diagnostic imaging)
- Propranolol
(therapeutic use)
- Splanchnic Circulation
- Treatment Outcome
- Ultrasonography, Doppler, Duplex
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