Fixed combination of losartan and hydrochlorothiazide and reduction of risk of stroke

Vasc Health Risk Manag. 2007;3(3):299-305.

Abstract

A fixed-dose combination of losartan/hydrochlorothiazide (HCTZ) therapy may be a logical choice for antihypertensive treatment, including for initial therapy in patients with blood pressure elevation >20/10 mmHg above treatment target. The renin-angiotensin-aldosterone-system-activating effect of hydrochlorothiazide augments the efficacy of blocking the angiotensin II type 1 (AT1) receptor with losartan. Some adverse effects associated with hydrochlorothiazide, including increased risk for new-onset diabetes mellitus, may be offset by losartan. Losartan was frequently administered with hydrochlorothiazide in the Losartan Intervention For Endpoint reduction in hypertension (LIFE) study, in which there was a 25% risk reduction for stroke in the losartan-based compared with the atenolol-based treatment group. The efficacy, tolerability, and convenience of losartan/HCTZ combination therapy may increase patient compliance and lower risk for stroke, a devastating outcome in patients with hypertension.

Publication types

  • Review

MeSH terms

  • Angiotensin II Type 1 Receptor Blockers / pharmacology*
  • Angiotensin II Type 1 Receptor Blockers / therapeutic use
  • Antihypertensive Agents / pharmacology*
  • Antihypertensive Agents / therapeutic use
  • Drug Therapy, Combination
  • Humans
  • Hydrochlorothiazide / pharmacology*
  • Hydrochlorothiazide / therapeutic use
  • Hypertension / drug therapy*
  • Hypertension / physiopathology
  • Losartan / pharmacology*
  • Losartan / therapeutic use
  • Risk Factors
  • Stroke / physiopathology
  • Stroke / prevention & control*

Substances

  • Angiotensin II Type 1 Receptor Blockers
  • Antihypertensive Agents
  • Hydrochlorothiazide
  • Losartan