Long-term central hemodynamic effects at rest and during exercise of losartan in essential hypertension

Background Losartan reduces blood pressure in patients with essential hyper tension, but the long-term central hemodynamic effects at rest and during e xercise are not known. Methods and Results After 8 months of losartan treatment (50 to 100 mg dail y, mean 82 mg), intra-arterial pressure was reduced from 165/102 mm Hg to 1 45/91 mm Hg at rest and from 193/104 mm Hg to 179/96 mm Hg during 100 W exe rcise in 28 patients with essential hypertension. Cardiac index and heart r ate remained unchanged, but total peripheral resistance index was reduced 1 2% to 15%. Stroke index was unchanged at rest but increased 7% to 9% during exercise. Twenty-four-hour ambulatory blood pressure was reduced 10% to 13 %. left ventricular mass was reduced 27% in patients with left ventricular hypertrophy (n = 18). Conclusion Losartan lowers blood pressure by reducing total peripheral resi stance at rest and during exercise but cardiac pump function is unchanged o r slightly improved. In patients with left ventricular hypertrophy, losarta n induces a sizeable reduction in left ventricular mass.