Renal hemodynamics in essential hypertensives treated with losartan.

Abstract

ACE-inhibitors are known to have special renal effects, i.e. they increase ERPF, decrease the filtration fraction and lower proteinuria. These effects can be due to a decrease in angiotensin II (AII) levels as well as an increase in bradykinin. New and more specific AII-receptor antagonists may help to distinguish between effects exerted by angiotensin II and those exerted by bradykinin. We investigated the effects of losartan in 9 patients with essential hypertension (sitting mean diastolic blood pressure 95-120 mmHg). Renal hemodynamics were measured by continuous inulin-and PAH-clearance (GFR and RPF) after stopping antihypertensive therapy for 1 week, followed by a 2-week placebo period and after a 4-week treatment phase with losartan (50 mg/die) followed by a therapy with an ACE-inhibitor (ramipril 5mg/die). Additionally, urine albumin excretion (UAE) was measured. Treatment of patients with essential hypertension with losartan resulted in a significant decrease of MAP after three weeks of treatment (121 +/- 8 mmHg under placebo and 114 +/- 10 mmHg under losartan; * = p < 0.05). MAP after four weeks of losartan treatment was 115 +/- 11 mmHg. Regarding changes in renal hemodynamics we could not demonstrate a significant change for neither losartan nor the ACE-inhibitor. Urine albumin excretion was reduced by both treatment regimens in correlation to the magnitude of blood pressure reduction. Our data indicate that losartan induced a significant reduction in MAP in patients with essential arterial hypertension with only moderate effects on renal hemodynamics.

• Authors: C M Erley, B Bader, M Scheu, S Wolf, N Braun, T Risler
• Journal: Clinical nephrology (Clin Nephrol) Vol. 43 Suppl 1 Pg. S8-11 (Jan 1995) ISSN: 0301-0430 [Print] Germany
• PMID: 7781206 (Publication Type: Clinical Trial, Clinical Trial, Phase III, Comparative Study, Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Antihypertensive Agents
• Biphenyl Compounds
• Imidazoles
• Tetrazoles
• Hydrochlorothiazide
• Losartan
• Ramipril

Topics

• Antihypertensive Agents (therapeutic use)
• Biphenyl Compounds (therapeutic use)
• Drug Therapy, Combination
• Female
• Humans
• Hydrochlorothiazide (therapeutic use)
• Imidazoles (therapeutic use)
• Kidney (drug effects)
• Losartan
• Male
• Middle Aged
• Ramipril (therapeutic use)
• Renal Circulation (drug effects)
• Renin-Angiotensin System (drug effects)
• Tetrazoles (therapeutic use)