| Chronic administration of losartan, an angiotensin II receptor antagonist, is not effective in reducing portal pressure in patients with preascitic cirrhosis. | |
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MedLine Citation:
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PMID: 15046234 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVES: Plasma angiotensin II (ANG II) concentrations are elevated in cirrhosis and have been implicated as a cause of portal hypertension. We aimed to study both the systemic and portal hemodynamics, and tolerability after chronic administration of losartan, an ANG II receptor antagonist. METHODS: Twelve patients with preascitic cirrhosis were studied: mean age of 53.8 +/- 3.3 yr; average Child-Pugh score of 5.8 +/- 0.3; alcohol etiology (5), hepatitis B/C (1/3), primary biliary cirrhosis (3). No patients were on diuretics or vasoactive medication. Hemodynamic measurements were performed at baseline and 4 weeks after daily administration of 25 mg losartan. RESULTS: There was no significant change in the hepatic venous pressure gradient (15.4 +/- 1.5 to 13.6 +/- 1.6 mmHg, -11.7%, p = NS), despite a significant reduction in the wedge hepatic venous pressure (20.3 +/- 1.8 to 17.3 +/- 1.8 mmHg, -14.8%, p < 0.05). Cardiac output, hepatic blood flow, systemic vascular resistance, creatinine clearance, and natriuresis were unaffected. The plasma renin activity increased significantly from 2.7 +/- 0.4 to 5.2 +/- 1.1 ng/ml/h (p < 0.05). There was a significant reduction in the mean arterial pressure from 96.9 +/- 3.3 to 89.3 +/- 3.5 mmHg, -7.8 +/- 3.0% (p = 0.02), with 1 patient experiencing symptomatic hypotension. CONCLUSIONS: Chronic administration of low-dose losartan does not lead to a significant reduction in the portal pressure gradient. Losartan is unlikely to be useful in the management of patients with early cirrhosis, who are at risk of variceal bleeding. |
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Authors:
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Dhiraj Tripathi; George Therapondos; Hock F Lui; Neil Johnston; David J Webb; Peter C Hayes |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: The American journal of gastroenterology Volume: 99 ISSN: 0002-9270 ISO Abbreviation: Am. J. Gastroenterol. Publication Date: 2004 Feb |
Date Detail:
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Created Date: 2004-03-29 Completed Date: 2004-05-06 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 0421030 Medline TA: Am J Gastroenterol Country: United States |
Other Details:
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Languages: eng Pagination: 390-4 Citation Subset: IM |
Affiliation:
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Liver Unit, Department of Medicine, Royal Infirmary, Edinburgh, UK. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Antihypertensive Agents
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pharmacology,
therapeutic use* Female Hemodynamics Humans Hypertension, Portal / drug therapy*, etiology, physiopathology Kidney / physiopathology Liver Cirrhosis / complications, drug therapy*, physiopathology Losartan / pharmacology, therapeutic use* Male Middle Aged Portal Pressure / drug effects* Receptors, Angiotensin / antagonists & inhibitors* Renin-Angiotensin System / physiology Treatment Outcome |
| Chemical | |
Reg. No./Substance:
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0/Antihypertensive Agents; 0/Receptors, Angiotensin; 114798-26-4/Losartan |
| Comments/Corrections | |
Comment In:
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Am J Gastroenterol. 2004 Nov;99(11):2282-3
[PMID:
15555016
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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