Does losartan lower heart rate
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The Impact of Losartan on Heart Rate: A Comprehensive Review
Introduction to Losartan and Heart Rate
Losartan, an angiotensin II receptor antagonist, is widely used for managing hypertension and heart failure. One of the key questions surrounding its use is whether it has any significant effect on heart rate. This article synthesizes findings from multiple studies to provide a clear understanding of losartan's impact on heart rate.
Losartan and Heart Rate Reduction in Heart Failure
Several studies have investigated the hemodynamic effects of losartan in patients with heart failure. A multicenter study demonstrated that losartan, particularly at doses of 25 mg and 50 mg, significantly lowered heart rate in patients with symptomatic heart failure over a 12-week period. This reduction in heart rate was observed alongside improvements in systemic vascular resistance and pulmonary capillary wedge pressure.
Heart Rate Variability and Autonomic Modulation
Losartan has also been shown to positively influence heart rate variability (HRV) and heart rate turbulence, which are important markers of autonomic function. In a study involving patients with ischemic cardiomyopathy, losartan significantly improved HRV parameters and heart rate turbulence indices over a 12-week period. These improvements suggest that losartan may enhance autonomic control of heart rate, contributing to its overall cardiovascular benefits.
Effects During Orthostatic and Vasodilatory Challenges
In hypertensive patients, losartan was found to maintain a significant vagal component during vasodilation, which is indicative of a balanced autonomic response. This was observed during a head-up tilt test and after the administration of trinitroglycerine, where losartan treatment prevented the sympathetic prevalence seen with placebo. This finding underscores losartan's role in stabilizing heart rate under stress conditions.
Animal Studies and Heart Rate
Animal studies provide additional insights into losartan's effects on heart rate. In salt-deplete dogs, losartan infusion led to a rise in heart rate, particularly at higher doses. However, in nonhuman primates, losartan did not significantly alter heart rate, even though it induced hypotension and hyper-reninemia. These mixed results from animal studies highlight the complexity of losartan's effects on heart rate, which may vary depending on the physiological context.
Protective Effects Against Cardiotoxicity
Interestingly, losartan has also been shown to counteract heart rate reductions induced by other medications. For instance, in a study investigating sorafenib-induced cardiotoxicity, losartan co-administration significantly reversed the negative effects on heart rate and myocardial contractility. This protective effect further supports losartan's beneficial role in managing heart rate and overall cardiac function.
Conclusion
In summary, losartan has been consistently shown to lower heart rate in patients with heart failure and improve heart rate variability and turbulence. Its ability to maintain autonomic balance during stress and protect against drug-induced cardiotoxicity further underscores its cardiovascular benefits. These findings make losartan a valuable option in the management of heart failure and hypertension, with positive implications for heart rate control.
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