EFFICACY AND SAFETY OF LOSARTAN IN HYPERTENSIVE PATIENTS WITH SIDE-EFFECTS INDUCED BY OTHER ANTIHYPERTENSIVE AGENTS

In an open-label trial, 54 patients with hypertension (22 men and 32 w omen, aged 42 to 67 years [mean age, 54 +/- 16 years]), who had discon tinued therapy with calcium channel blockers (group 1, n = 15) or angi otensin-converting enzyme (ACE) inhibitors (group 2, n = 39) after 30 to 40 days because of peripheral edema or dry cough, respectively, mer e treated with losartan 50 mg/d orally for 30 days. Mean baseline valu es for sitting systolic and diastolic blood pressures and heart rate w ere 164.3 +/- 4.9 mm Hg, 102.3 +/- 5.4 mmHg, and 67.0 +/- 6.5 beats/mi n, 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 tr eatment 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 I and 136.5 +/- 8.9/80.6 a 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 observe d 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 altere d by the drug. Only two patients exhibited mild dizziness, which disap peared during the trial. Results of this study indicate that losartan is an effective, well-tolerated drug for the treatment of essential hy pertension, especially in patients with reduced tolerance to calcium c hannel blockers or ACE inhibitors.