Effect of short-term losartan treatment in patients with primary aldosteronism and essential hypertension

The aim of this study sects to investigate the effect of short-term treatme nt with losartan, a selective and competitive angiotensin II(AngII) recepto r blocker; on vascular endothelial growth factor (VEGF), active renin and k allikrein activity (KA) in patients with essential hypertension and primary aldosteronism. Nine patients with primary aldosteronism (5 with Conn adeno ma and 4 with idiopathic hyperaldosteronism) and 9 patients with essential hypertension were included ill the study. Systolic and diastolic blood pres sure decreased significantly after losartan treatment in both patient group s. Plasma and urinary Kallikrein activity were significantly higher ire pri mary aldosteronism in comparison with essential hypertension. There were no significant changes in the active renin and aldosterone in patients with p rimary aldosteronism after treatment. Plasma and urinary KA decreased signi ficantly after losartan administration ill both groups. Serum VEGF levels i n primary aldosteronism were not significantly different from those in esse ntial hypertension anti did not change significantly after treatment ill ei ther group. In conclusion, losartan, in usual therapeutic doses, lowers blo od pressure in patients with primary aldosteronism and essential hypertensi on. This marked antihypertensive effect in primary aldosteronism could he e xplained predominantly by blockade of tissue resin-angiotensin system (RAS) . The variations in KA could be due to hemodynamic changes. VEGF is riot li kely to be involved in the action of losartan. (C) 2001 Prous Science. All rights reserved.