This may result from a higher prevalence of diastolic dysfunction in women (25). Exercise training and losartan treatment protocols ET was started when the rats were 8 weeks old and consisted of 18 weeks of running on a motor treadmill (ESD model 01 FUNBEC, São Paulo, … Circulation 1998; 98: 2282. In: Heart Disease . An increase in arterial systolic pressure increases LV afterload, thus slowing LV relaxation and reducing the extent of ejection. In the RENAAL study -- a premarketing study -- 14 percent of the 1,513 participants reported feelings of fatigue. All rights reserved. : "Pharmacokinetics of losartan, an angiotensin II receptor antagonist, and its active metabolite EXP3174 in humans". Little W.C and Braunwald E: Assessment of cardiac function. Circ Res 1996; 78: 880. Thus, it is possible that the beneficial effects of losartan would not persist with a longer duration of therapy. The patients exercised for 11 ± 2.5 min on the initial exercise test, stopping because of dyspnea or fatigue. Circulation 1985; 72: 853. The subjects then underwent a baseline treadmill exercise test using the modified Bruce Protocol (14). Thus, a change in the baseline diastolic function is not the mechanism of losartan’s action. Drug information provided by: IBM Micromedex Along with its needed effects, a medicine may cause some unwanted effects. Thus, the benefit we observed with losartan occurred in addition to any beneficial effects of these other medications. Losartan/hydrochlorothiazide is a prescription medication. Twenty patients completed the study: 4 men and 16 women. --Juha. But angiotensin is synthetized in the lungs, and this is surely not coincidental, i.e., it must have a function there, too. Immediately after exercise the Doppler-echocardiogram was repeated. I have a strong subjective feeling that losartan impairs the ventilatory function of my lungs when I am engaged in strenuos sports, e.g., running, i.e., I become short of breadth much more easily than before. The transmitral Doppler measurements were measured at rest and immediately postexercise. Edited by Braunwald E. Philadelphia: W.B. The mean age was 64 ± 10 years (range 53 to 79 years). We found in patients with Doppler-echocardiographic evidence of mild LV diastolic dysfunction and a marked hypertensive response to exercise that treatment with an Ang II receptor blocker blunted the increase in systolic BP with exercise, improved exercise tolerance and enhanced the quality of life. These improvements occurred despite relatively good exercise tolerance (11.3 ± 2.5 min), mild symptoms and normal SBP at baseline. It is also possible that some of the beneficial effect was due to an interaction of losartan and the baseline medications that were continued throughout the study. in Medline) on the actions of AT blockers (or ACE inhibitors) on lung function, and my cardioligists don't no either. It is “an angiotensin receptor blocker” (also called an angiotensin-II receptor antagonist (AIIRA)). Patients with other diseases that could limit exercise tolerance were excluded. i take 100mg losartan daily, i've lost weight, cut out caffeine and alcohol.and exercise regularly .my bp is consistant 125/77. Resting LV volumes and ejection fraction were measured from the apical four-chamber view using the modified Simpson’s rule method (15). : "Use of the Living With Heart Failure questionnaire to ascertain patients’ perspectives on improvement in quality of life versus risk of drug-induced death". During control, patients were able to exercise for 11.3 ± 2.5 (mean ± SD) min, with a peak exercise SBP of 226 ± 24 mm Hg. Exercise training upregulated the nitric oxide pathway, whereas losartan … We measured exercise tolerance using the Modified Bruce Protocol of treadmill exercise (14). Side effects. The resting mitral valve E/A ratio was 0.75 ± 0.13 and less than 1.0 in all subjects (an entry criteria). The ability to increase the cardiac output during exercise without an abnormal elevation in left atrial pressure depends on the capacity of the left ventricle to enhance its diastolic filling (4). The patient was withdrawn from the study. Discuss your symptoms on and off of the medication and the risks of discontinuation of losartan. However, a longer course of therapy might have produced improvement in diastolic function by inducing regression in patients with LV hypertrophy. Your … Lowering the arterial pressure produces a rapid resolution of the pulmonary edema. Losartan did not improve exercise … These medications were continued during the study. Prog Cardiovasc Dis 1990; 32: 273. However, exercise tolerance assessed by the quality of life questionnaire also improved with losartan. Dr. Michael Yap answered 14 years … These medications may interact and cause very harmful effects. 4. Similarly, using only the questions directly assessing exercise tolerance, the score improved on losartan (5.2 ± 7.3) compared to placebo (9.9 ± 7.7, p < 0.05), which was similar to control (9.9 ± 7.9). Sixteen patients had a past history of hypertension but had resting SBP ≤150 mm Hg on medications at the time of entry into the study (Table 1). In patients with Doppler evidence of diastolic dysfunction at rest and a hypertensive response to exercise, Ang II receptor blockade blunts the hypertensive response to exercise, increases exercise tolerance and improves quality of life. Many elderly subjects and patients with hypertension or left ventricular (LV) hypertrophy have Doppler echocardiographic evidence of impaired diastolic function, but do not have any symptoms of heart failure at rest (1–3). A randomized, double-blind study of 6 months of losartan 50 mg or hydrochlorothiazide (HCTZ) 12.5 mg was performed in 40 subjects with left ventricular diastolic dysfunction (mitral flow velocity E/A ratio <1), exercise … Most athletes tolerate ARBs well, but it sounds … With placebo, there was no improvement in exercise duration (11.0 ± 2.0 min) or peak exercise SBP (217 ± 26 mm Hg). Yet I cannot find any information (e.g. Nishimura R.A and Tajik A.J: "Evaluation of diastolic filling of left ventricle in health and disease: Doppler echocardiography is the clinician’s Rosetta stone". Table 2. Our findings also demonstrate the role of Ang II acting through AT1receptors, in contributing to the increase in SBP during exercise. We may earn commission if you buy from a link. Neither losartan nor placebo had any significant effect on LV end-diastolic volume, IVRT, mitral E/A ratio, or E-wave deceleration (Table 4). Senni M, Tribouilloy C.M, Rodeheffer R.Jet al. Haber H.L, Powers E.R, Gimple L.Wet al. ☆ This work was supported in part by research grants from the NIH (AG12257) and from Merck Research Laboratories. After two weeks of losartan, baseline BP was unaltered, but peak SBP during exercise decreased to 193 ± 27 mm Hg (p < 0.05 vs. baseline and placebo), and exercise time increased to 12.3 ± 2.6 min (p < 0.05 vs. baseline and placebo). Exercise and losartan improved acetylcholine-mediated vasorelaxation to the same extent, but by different mechanisms. Bruce R.A: "Exercise testing methods and interpretations". I (47 year-old male) had a mild cardiac infarct in February 2005 and since on losartan (Cozaar) medication. Losartan is a medicine widely used to treat high blood pressure and heart failure, and to protect your kidneys if you have both kidney disease and diabetes.. Losartan … when can i half dose? † p < 0.05 (Losartan vs. Baseline). ), Everything You Need to Know About Hip Injuries, These Pace Charts Will Guide Your Virtual Race. 24. The losartan may lower your blood pressure to a level that causes fatigue and shortness of breath at a lower level of exertion. 9. Side Effects. : "Altered ventricular and myocyte response to angiotensin II in pacing-induced heart failure". Resolution of your symptoms when not taking the medication and recurrence of the problem with resumption of losartan certainly raises suspicion. Serious Interactions. The clinical … … on exercise tolerance and quality of life. Quality of life improved with losartan (18 ± 22, p < 0.05) compared to placebo (22 ± 26). 18. During control, patients were able to exercise for 11.3 +/- 2.5 (mean +/- SD) min, with a peak exercise SBP of 226 +/- 24 mm Hg. Adv Cardiol 1978; 24: 6. ... You can also lose water by sweating, so drink plenty of water during exercise or in hot weather. Although the patients’ mean BP was 143/79 mm Hg at rest on their baseline medication and not reduced further at rest by the addition of losartan, it is possible that more aggressive antihypertensive therapy with agents other than an Ang II receptor blocker could have produced a similar improvement in exercise tolerance. J Card Fail 1995; 1: 201. Thank you so much for your consideration! Exercise, exercise and losartan, and losartan … This is dramatically apparent in patients who develop flash pulmonary edema in association with a marked increase in systolic BP (SBP) (>200 mm Hg) (5). Circulation 1994; 89: 2241. 20. J Am Soc Echocardiogr 1989; 2: 358. All baseline medications were continued during the study. In the mean time, try taking your medication after your workouts. © 2021 American College of Cardiology Foundation. Clin Cardiol 1998; 21: 5. Sixteen of the patients in our study were taking a variety of common antihypertensive medications, including beta-adrenergic blocking agents, ACE inhibitors, and calcium channel blockers.
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