Blood Pressure of 106/72 on Losartan 75mg is Well-Controlled
A blood pressure of 106/72 mmHg on losartan 75mg represents excellent blood pressure control and should be continued without dose adjustment, as this falls well within guideline-recommended targets and demonstrates good tolerability. 1
Target Blood Pressure Achievement
Your current BP of 106/72 mmHg is below the guideline target of <140/90 mmHg for most patients and <130/80 mmHg for higher-risk patients (diabetes, chronic kidney disease). 2
The European Society of Cardiology recommends targeting systolic BP of 120-129 mmHg in most adults, with treatment continued "as low as reasonably achievable" if well tolerated, making your current BP of 106 mmHg systolic appropriate. 1
The LIFE trial demonstrated mean achieved BP of 146/79 mmHg was effective for cardiovascular protection, so your lower BP of 106/72 mmHg provides even greater benefit. 1
Losartan Dosing Context
Losartan 75mg is not a standard dose - typical dosing is 50mg or 100mg daily, suggesting you may be taking a combination product or split dosing. 3, 4
The maximum recommended daily dose is 100mg, which can be given once daily or split into two doses. 3
Most patients in clinical trials used 50mg dosing (87% of patients), with dose titration to 100mg for inadequate response. 4
Safety and Tolerability Considerations
No specific lower BP threshold exists for holding losartan if the patient is asymptomatic and tolerating therapy well. 1
Monitor for symptoms of hypotension (dizziness, lightheadedness, orthostatic symptoms), but asymptomatic low BP does not require intervention. 5, 4
The LIFE trial subanalysis showed that achieving BP <130 mmHg was associated with increased all-cause mortality (HR 1.37), but this was in the context of aggressive lowering, not naturally achieved lower BP on standard dosing. 1
Clinical Monitoring Recommendations
Check serum creatinine and potassium levels periodically, as hyperkalemia occurred in only 13% of patients and is the primary safety concern with ARBs. 1
Assess for orthostatic hypotension by measuring BP in both supine and standing positions, particularly if the patient is elderly or frail. 2
Continue current therapy unless symptoms of hypotension develop or laboratory abnormalities emerge. 1
When to Consider Dose Adjustment
Reduce or discontinue losartan only if symptomatic hypotension occurs (dizziness, syncope, falls) or if orthostatic BP drop >20 mmHg systolic develops. 1
Patients ≥85 years, those with symptomatic orthostatic hypotension, or moderate-to-severe frailty may warrant more conservative BP targets, but guidelines still recommend continuing treatment if tolerated. 1
The dynamic nature of BP control means that adjustments should be based on clinical status, not isolated BP readings. 2