Document Detail

Comparative effects of losartan and nifedipine therapy on exercise capacity, Doppler echocardiographic parameters and endothelin levels in patients with secondary pulmonary hypertension.
MedLine Citation:
PMID:  20150004     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: Pulmonary hypertension (PHT) is associated with high mortality and morbidity. Interest has increased in the use of drugs that, because of their neurohumoral inhibitory effects, inhibit the renin angiotensin system. In this study, we sought to examine whether losartan therapy is non-inferior to nifedipine in the treatment of secondary PHT. METHODS: This prospective randomized study consisted of 63 patients (mean age, 63.7+/- 9.1 years) with PHT who underwent Doppler echocardiographic examination. A baseline 6-minute walk test (6MWT) and cardiopulmonary exercise test (CPET) were performed, and the endothelin-1 level of each patient was measured. Patients were assigned to two groups receiving treatment with nifedipine (n=30) and losartan (n=33). After 2 months of treatment, those measurements were repeated. The groups were compared with regard to effectiveness for the studied parameters using 2*2 factorial ANOVA design for repeated measurements. RESULTS: When posttreatment values were compared with baseline values in both groups, the following statistically significant changes were noted: the mean values of both mean and systolic pulmonary artery pressures (PAPs) were reduced (p<0.05) on Doppler echocardiography; exercise duration, work rate, and end-tidal carbon dioxide pressure (PETCO2) were higher (p<0.05 for all); and the minute ventilation (VE) and ventilatory equivalents for carbon dioxide (VE/VCO2) were lower (p<0.05 for both) according to the results of a CPET. No statistically significant change was noted in the mean levels of serum endothelin-1. With regard to the results cited above, no statistically significant difference was detected between the losartan and nifedipine groups (p>0.05). CONCLUSION: The findings of this study indicate that losartan is non-inferior to nifedipine for reducing PAP and improving exercise capacity. However, the short-term use of losartan or nifedipine had no statistically significant effect on endothelin-1 levels in patients with secondary PHT.
Serife Savaş Bozbaş; Hüseyin Bozbaş; Asli Atar; Gaye Ulubay; Füsun Oner Eyüboğlu
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Publication Detail:
Type:  Comparative Study; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Anadolu kardiyoloji dergisi : AKD = the Anatolian journal of cardiology     Volume:  10     ISSN:  1308-0032     ISO Abbreviation:  Anadolu Kardiyol Derg     Publication Date:  2010 Feb 
Date Detail:
Created Date:  2010-02-12     Completed Date:  2010-05-28     Revised Date:  2010-07-14    
Medline Journal Info:
Nlm Unique ID:  101095069     Medline TA:  Anadolu Kardiyol Derg     Country:  Turkey    
Other Details:
Languages:  eng     Pagination:  43-9     Citation Subset:  IM    
Department of Pulmonary Medicine, Faculty of Medicine, Başkent University, Ankara, Turkey.
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MeSH Terms
Angiotensin II Type 1 Receptor Blockers / therapeutic use
Anti-Arrhythmia Agents / therapeutic use
Arrhythmias, Cardiac / drug therapy,  physiopathology
Diastole / drug effects
Echocardiography, Doppler
Exercise Test / methods
Hypertension, Pulmonary / drug therapy*,  ultrasonography
Hypertrophy, Left Ventricular / physiopathology
Middle Aged
Prospective Studies
Vasodilator Agents / therapeutic use*
Reg. No./Substance:
0/Angiotensin II Type 1 Receptor Blockers; 0/Anti-Arrhythmia Agents; 0/Vasodilator Agents; 114798-26-4/Losartan; 21829-25-4/Nifedipine
Comment In:
Anadolu Kardiyol Derg. 2010 Feb;10(1):50-1   [PMID:  20150005 ]

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