The antiarrhythmic potential of angiotensin II antagonism: Experience withlosartan

A large body of literature accumulated over the past several years supports the notion that inhibition of the renin-angiotensin system protects the he art and other target organs from hypertensive complications. Various studie s have shown that angiotensin-converting enzyme inhibitors reduce morbidity and mortality in the setting of ischemic heart disease and/or congestive h eart failure. The improvement in survival has been attributed in part to a significant decrease in the incidence of sudden deaths, possibly due to a d ecrease in complex arrhythmia episodes. Recently, the angiotensin II type 1 receptor antagonist losartan was shown to reduce mortality by 46% compared with captopril in older patients with chronic congestive heart failure. Th is paper briefly reviews the arrhythmogenic properties of angiotensin II an d the possible pharmacologic mechanisms for the antiarrhythmogenic potentia l of losartan. (C) 2000 American Journal of Hypertension, Ltd.