Losartan 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. Its effects on heart rate (HR) and heart rate variability (HRV) have been the subject of numerous studies. This article synthesizes the findings from various research papers to provide a clear understanding of how losartan influences heart rate and related cardiovascular parameters.
Losartan and Heart Rate Variability in Heart Failure
Improvement in Heart Rate Variability
Research indicates that losartan significantly improves heart rate variability (HRV) in patients with heart failure due to ischemic cardiomyopathy. A study involving 77 patients demonstrated that a 12-week losartan therapy led to significant improvements in several HRV parameters, including SDNN, SDANN, and RMSSD, among others. These improvements suggest enhanced autonomic regulation of the heart, which is crucial for patients with heart failure.
Heart Rate Turbulence
In the same study, losartan also improved heart rate turbulence indices, which are predictive of mortality in heart failure patients. The turbulence onset decreased, and the turbulence slope increased significantly, indicating a better autonomic response to heart rate changes.
Losartan's Effect on Heart Rate in Hypertensive Patients
Variability During Vasodilation
A study on hypertensive patients treated with losartan showed that the drug helps maintain a significant vagal component during vasodilation, thus preventing an unbalanced autonomic modulation. This was evident as losartan treatment did not significantly alter the low-frequency or high-frequency power of heart rate variability during orthostatic and vasodilatory stimuli, unlike placebo.
Comparative Studies with Other Antihypertensives
In a comparative trial, losartan was found to be less effective than controlled-onset, extended-release verapamil in lowering heart rate over a 24-hour period. However, it was comparable to enalapril in its effects on blood pressure and heart rate during the post-awakening morning phase.
Losartan in Animal Studies
Effects in Nonhuman Primates
Studies in nonhuman primates have shown that losartan does not significantly alter heart rate in either normal or sodium-depleted conditions. This suggests that while losartan effectively manages blood pressure and hormonal responses, its direct impact on heart rate may be minimal in these models.
Responses in Salt-Deplete Dogs
In salt-deplete dogs, losartan caused a rise in heart rate at higher doses, indicating a dose-dependent effect on heart rate in response to angiotensin II receptor blockade.
Losartan and Atrial Fibrillation
Prevention of New-Onset Atrial Fibrillation
The Losartan Intervention For Endpoint Reduction in Hypertension (LIFE) study found that losartan was more effective than atenolol in preventing new-onset atrial fibrillation (AF). Patients on losartan had a lower incidence of AF and associated strokes, suggesting that losartan may offer protective benefits against arrhythmias beyond its blood pressure-lowering effects.
Conclusion
Losartan has a multifaceted impact on heart rate and heart rate variability, particularly in patients with heart failure and hypertension. It improves HRV and heart rate turbulence, maintains autonomic balance during vasodilation, and may prevent new-onset atrial fibrillation. While its direct effects on heart rate can vary depending on the context and dosage, losartan's overall cardiovascular benefits make it a valuable therapeutic option.
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