Losartan is an Effective Medication for Hypertension
Yes, losartan (an angiotensin II receptor blocker) is definitively used to treat hypertension and is FDA-approved for this indication. 1
Indications and Mechanism
- Losartan is specifically indicated for the treatment of hypertension in adults and pediatric patients 6 years of age and older to lower blood pressure 1
- As an angiotensin II receptor blocker (ARB), losartan works by selectively blocking the binding of angiotensin II to the AT1 receptors, thereby preventing the vasoconstriction and aldosterone-secreting effects of angiotensin II 2
- Losartan has been shown to effectively lower blood pressure, with reductions comparable to other antihypertensive medications such as enalapril, atenolol, and felodipine 3
Clinical Benefits Beyond Blood Pressure Control
- Losartan reduces the risk of stroke in patients with hypertension and left ventricular hypertrophy, though this benefit may not apply to Black patients 1
- In the LIFE study, losartan demonstrated a lower risk for cardiovascular endpoints (RR: 0.76) and all-cause mortality (RR: 0.61) compared to atenolol in patients with hypertension and left ventricular hypertrophy 4, 5
- Losartan is particularly beneficial for patients with type 2 diabetes and nephropathy, as it reduces the rate of progression of kidney disease 1, 6
Special Populations and Considerations
- In patients with type 2 diabetes and nephropathy, losartan significantly reduced the incidence of doubling of serum creatinine, end-stage kidney disease, and death by 16% compared to placebo in the RENAAL trial 4
- Losartan is especially effective in patients with albuminuria, as it provides renoprotective effects beyond blood pressure control 4, 6
- For elderly patients with hypertension, losartan has shown similar efficacy to other antihypertensive agents and is generally well-tolerated 7
Dosing and Administration
- Treatment typically begins with a low dose and can be titrated up to the highest approved dose the patient can tolerate 4
- Losartan may be administered with or without food 1
- If blood pressure goals are not achieved with losartan monotherapy, additional antihypertensive medications may be added 5, 1
Safety Profile and Monitoring
- Losartan is generally well-tolerated with an overall incidence of adverse events similar to that of placebo 1, 3
- Common side effects include dizziness (3% vs. 2% with placebo), upper respiratory infection, nasal congestion, and back pain 1
- Unlike ACE inhibitors, losartan is associated with a significantly lower incidence of cough 1
- Monitoring of renal function and serum potassium is recommended, especially in patients with pre-existing renal impairment 4, 5
- Losartan is contraindicated during pregnancy as it can cause harm or death to an unborn baby 1
Practical Considerations
- Losartan can be used as monotherapy or in combination with other antihypertensive agents, particularly thiazide diuretics for enhanced efficacy 1, 3
- Many patients will require more than one drug to achieve blood pressure goals 1
- Target blood pressure should be <130/80 mmHg for patients with diabetes or chronic kidney disease 4, 5
Losartan represents an important option in the management of hypertension, particularly for patients with comorbidities such as left ventricular hypertrophy, type 2 diabetes, or kidney disease.