Metoprolol losartan

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Comparative Analysis of Metoprolol and Losartan in Cardiovascular Treatments

Prevention of Postoperative Atrial Fibrillation

Keywords: Metoprolol, Losartan, Postoperative Atrial Fibrillation, Lung Cancer Surgery

A study investigated the efficacy of metoprolol and losartan in preventing postoperative atrial fibrillation (AF) in high-risk patients undergoing lung cancer surgery. The trial included 320 patients with elevated NT-proBNP levels, divided into three groups: metoprolol, losartan, and control. Both metoprolol and losartan significantly reduced the incidence of postoperative AF compared to the control group, with no significant difference between the two drugs .

Effects on Left Ventricular and Aortic Function in Chronic Aortic Regurgitation

Keywords: Metoprolol, Losartan, Chronic Aortic Regurgitation, Left Ventricular Function

In patients with chronic aortic regurgitation (AR), a study compared the short-term effects of losartan and metoprolol on left ventricular (LV) and aortic function. Metoprolol was associated with a lower heart rate and cardiac power index but a higher aortic regurgitant fraction compared to losartan. Additionally, metoprolol led to a greater reduction in aortic distensibility during exercise .

Insulin Sensitivity in Hypertensive Subjects

Keywords: Losartan, Metoprolol, Insulin Sensitivity, Hypertension

A randomized study evaluated the effects of losartan and metoprolol on insulin sensitivity in hypertensive subjects. Both drugs did not significantly alter insulin sensitivity, glucose oxidation, or non-oxidation. The study concluded that losartan and metoprolol are metabolically neutral, with no significant adverse effects on glucose and lipid metabolism .

Blood Pressure Reduction in Hypertension

Keywords: Metoprolol, Losartan, Hypertension, Blood Pressure

A comparative study assessed the efficacy of a fixed-dose combination of metoprolol extended-release (XL) and amlodipine versus losartan plus amlodipine in patients with mild-to-moderate hypertension. Both combinations significantly reduced systolic and diastolic blood pressure, with no significant difference in efficacy or response rate between the two treatment groups .

Treatment of Congestive Heart Failure

Keywords: Metoprolol, Losartan, Congestive Heart Failure, Cardiac Function

Research on patients with congestive heart failure (CHF) demonstrated that a combination of metoprolol and losartan significantly improved cardiac function and quality of life compared to either drug alone. The combination therapy was found to be safe and effective, enhancing left ventricular ejection fraction (LVEF) and reducing norepinephrine levels 57.

Cardiac Remodeling Post-Myocardial Infarction

Keywords: Metoprolol, Losartan, Myocardial Infarction, Cardiac Remodeling

Studies on myocardial infarction (MI) patients revealed divergent effects of metoprolol and losartan on cardiac remodeling. Metoprolol improved left ventricular systolic function and increased c-kit+ cell proliferation, while losartan was associated with adverse structural remodeling, increased apoptosis, and fibrosis 68. Both drugs, however, were effective in reducing left ventricular hypertrophy and improving hemodynamic parameters in isoproterenol-induced heart failure models .

Diastolic Function in Hypertension with Left Ventricular Hypertrophy

Keywords: Losartan, Metoprolol, Left Ventricular Hypertrophy, Diastolic Function

A study comparing losartan alone and in combination with metoprolol in patients with hypertension and left ventricular hypertrophy found that the combination therapy significantly improved left ventricular diastolic function compared to losartan alone. This suggests a synergistic effect of the two drugs in managing hypertensive heart disease .

Conclusion

Metoprolol and losartan are both effective in various cardiovascular conditions, including postoperative atrial fibrillation, chronic aortic regurgitation, hypertension, and heart failure. While both drugs have unique benefits, combination therapies often provide superior outcomes, particularly in complex conditions like congestive heart failure and hypertensive heart disease. Further research is needed to fully understand the long-term clinical implications of these findings.

Sources and full results

Most relevant research papers on this topic

Prevention of Atrial Fibrillation in High-risk Patients Undergoing Lung Cancer Surgery: The PRESAGE Trial

Prophylactic treatment with metoprolol or losartan, initiated soon after lung cancer surgery in patients with high NT-proBNP levels, significantly reduced the occurrence of postoperative atrial fibrillation.

RCTLarge Human Trial

2016·

55citations

·D. Cardinale et al.

Comparison of effects of losartan and metoprolol on left ventricular and aortic function at rest and during exercise in chronic aortic regurgitation

Losartan and metoprolol have significantly different short-term effects on aortic regurgitation and left ventricular and aortic function in chronic aortic regurgitation patients.

RCTRigorous Journal

2018·

7citations

·P. Roberts et al.

Effects of losartan on insulin sensitivity in hypertensive subjects.

Losartan effectively lowers blood pressure without significantly affecting insulin sensitivity or glucose metabolism in hypertensive subjects.

RCT

1996·

60citations

·M. Laakso et al.

Efficacy and Tolerability of a Fixed-Dose Combination of Metoprolol Extended Release/Amlodipine in Patients with Mild-to-Moderate Hypertension

Metoprolol XL/amlodipine fixed-dose combination is as effective and well-tolerated as losartan plus amlodipine in treating mild-to-moderate essential hypertension.

RCTRigorous Journal

2010·

13citations

·A. Pareek et al.

Clinical Observation on 196 Patients with Congestive Heart Failure Treated by Metoprolol Combined with Losartan Potassium

Metoprolol combined with losartan potassium is a safe and effective treatment for congestive heart failure patients, improving cardiac function and quality of life.

RCT

2009·

0citations

·Li Long-gui

Divergent Effects of Losartan and Metoprolol on Cardiac Remodeling, C‐kit+ Cells, Proliferation and Apoptosis in the Left Ventricle after Myocardial Infarction

Metoprolol improves left ventricular function after myocardial infarction, while losartan worsens it and increases apoptosis and fibrosis in the peri-infarct region.

Non-RCTAnimal Study

2009·

20citations

·R. Serpi et al.

Effect of losartan and metoprolol on heart function in aged severe chronic heart failure

Losartan and metoprolol combination therapy provides better clinical results and improved life quality in elderly patients with severe chronic heart failure compared to losartan therapy alone.

RCT

2006·

0citations

·Fu Ya

Effect of losartan, metoprolol on left ventricular rmodeling in acute myocardial infarction

Losartan has a better effect on improving left ventricular remodeling in acute myocardial infarction patients compared to metoprolol.

RCT

2003·

0citations

·T. Bao

Effects of beta-receptor blockade and angiotensin II type I receptor antagonism in isoproterenol-induced heart failure in the rat.

Losartan and metoprolol effectively reduce hemodynamic alterations and left ventricular hypertrophy in isoproterenol-induced heart failure in rats, with early application of losartan showing beneficial effects on myocardial structure.

1999·

31citations

·D. Grimm et al.

Effects of losartan plus metoprolol on hypertrophic cardiac muscle and diastolic function in hypertension with left ventricular hypertrophy

Losartan plus metoprolol treatment can improve left ventricular diastolic function in essential hypertension patients with left ventricular hypertrophy.

2002·

0citations

·Huang Xiuli

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