Losartan for high blood pressure

Losartan, a specific blocker of angiotensin II (AT1) receptors, has demonstrated a potent antihypertensive effect with a good safety and tolerance profile. The glomerular effects of losartan could be useful in transplanted patients.

It is the first of a new class of drugs to be introduced for clinical use in hypertension. Losartan is an orally active agent that undergoes substantial first-pass metabolism by cytochrome P450 enzymes. It is converted, in part, to an active carboxylic acid metabolite that is responsible for most of the angiotensin II receptor antagonism that follows losartan treatment.

Angiotensin-II is a substance produced in the body which binds to receptors in blood vessels, causing them to tighten. This results in an increase in blood pressure. Losartan prevents the binding of angiotensin-II to these receptors, causing the blood vessels to relax which in turn lowers the blood pressure.

In patients with essential hypertension, once-daily doses of 50 or 100 mg losartan have been shown to effectively lower BP throughout the 24-hour dosing interval and to be well tolerated.
Losartan for high blood pressure

Renovascular hypertension

In most Westernized countries, and especially among older individuals, renovascular hypertension is the most remediable cause of elevated blood pressure.

Renovascular hypertension is a reversible cause of hypertension secondary to a decrease in renal perfusion pressure which activates the renin-angiotensin system and leads to the release of rennin and the production of angiotensin II.  It is a progressive disorder that can result in serious complications without adequate treatment.

Angiotensin II increases sodium reabsorption and induces postglomeruler and systemic arterial vasoconstriction, causing renovascular hypertension. The prevalence of renovascular hypertension was estimated at about 5% of all hypertensive individuals but it is varied form less than 1% to more than 50% depending on the degree of screening in the study population.

With prevalence of about 5%, renovascular disease represents the most frequent cause of secondary hypertension.

Unlike the diagnosis of most other cardiovascular and nephorologic conditions, renovascular hypertension can be diagnosed only retrospectively, by means of a physiologic blood pressure (BP) response to an intervention.
Renovascular hypertension