Manuscript accepted on :21-11-2019
Published online on: 06-11-2019
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484Pratibha S. Salve1*
, Chitra C. Khanwelkar1, Preeti S. Salve2, Vandana M. Thorat1, Somnath M. Matule1 and Seshla S1
1Department of Pharmacology, Krishna Institute of Medical Sciences, Karad-415110, Maharashtra
2Department of Pharmaceutical Chemistry, KLE College of Pharmacy, KAHER, Nehru nagar, Belagavi-590 010, Karnataka, India
Corresponding Author E-mail: salvepratibha@yahoo.in
DOI : https://dx.doi.org/10.13005/bpj/1813
Abstract
The renin–angiotensin system (RAS) provides the most powerful regulation of blood pressure and angiotensin II is the primary mediator in this system. The binding of angiotensin II to AT1 receptors produces a number of potentially harmful effects that include increase in blood pressure, progression of atherosclerosis, myocardial and vascular hypertrophy. Losartan was the first ARB and found to reduce the risk of stroke, new onset of diabetes and to have a proven benefit in stroke. The present study was designed to evaluate the effect of losartan on different biochemical parameters viz; blood sugar, lipid profile, uric acid and serum electrolytes. 29 newly diagnosed patients of either gender with essential hypertension were included in the study. Baseline readings of lipid profile, serum electrolytes, fasting blood sugar and uric acid were recorded before starting losartan monotherapy and were repeated after six months. After comparing the means, it was revealed that there was a significant increase in HDL cholesterol and a significant decrease in serum uric acid levels after six months of losartan therapy. No significant difference was found in blood sugar and electrolyte levels. These findings suggest that losartan can be an attractive option for the treatment of hypertension and for metabolic syndrome.
Keywords
Blood Sugar Level; Essential Hypertension; Lipid Profile; Losartan; Serum Electrolytes; Serum Uric Acid
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| Copy the following to cite this article: Salve P. S, Khanwelkar C. C, Salve P. S, Thorat V. M, Matule S. M, Seshla S. Effect of Losartan on Different Biochemical Parameters in Essential Hypertensive Patients.Biomed Pharmacol J 2019;12(4). |
| Copy the following to cite this URL: Salve P. S, Khanwelkar C. C, Salve P. S, Thorat V. M, Matule S. M, Seshla S. Effect of Losartan on Different Biochemical Parameters in Essential Hypertensive Patients.Biomed Pharmacol J 2019;12(4).Available from: https://bit.ly/2oPNBVO |
Introduction
Hypertension being a common health problem, is usually a progressive disorder, and one of the leading causes of death and disability worldwide. It is a major risk factor for cardiovascular diseases1,2. Lowering of elevated blood pressure decreases morbidity from cardiovascular, cerebral and renal failure3. Essential hypertension is a condition where the cause for rise in blood pressure is not known4. The beneficial effects of antihypertensive agents on cardiovascular system can be counter balanced by the induction of metabolic disorders. The modifications in various metabolic parameters like lipids, serum electrolytes, serum uric acid, blood sugar level etc. are responsible for different adverse drug reactions of antihypertensive drugs. It might also have potential to produce secondary morbidities after long term use. Several studies comparing antihypertensive agents have shown differences in risk reduction in cardiovascular diseases (CVD) with a similar blood pressure lowering effect, suggesting that specific pharmacological mechanisms may be involved2,3.
The renin angiotensin aldosterone system (RAAS) is targeted by some of the most widely used antihypertensive medication classes like angiotensin receptor blockers (ARBs), aldosterone antagonists, angiotensin converting enzyme inhibitors (ACEIs) and direct rennin inhibitors5,6. ARBs are increasingly used in the treatment of hypertension because of fewer side effects with blood pressure lowering abilities. The first ARB discovered was losartan. It is a competitive antagonist and an inverse agonist, about 10,000 times more selective for AT1 than AT2 receptors. It generates active metabolite which is more potent and non-competitively blocks the AT1 receptor with higher affinity. Blockade of AT1 receptors causes inhibition of vasoconstriction, sodium retention and reduces blood pressure7,8.
The present study was designed to evaluate the effect of losartan monodrug therapy on different biochemical parameters. Various studies carried out with losartan showed no significant changes in the biochemical parameters. However, there have also been some studies which have shown significant favorable changes in the various parameters9. Therefore, the present study was designed to observe the effect of losartan on different biochemical parameters in essential hypertension.
Materials and Methods
The present work was an open prospective study conducted in an OPD of medicine department of 50 bed multi-specialty private hospital in western Maharashtra. Newly diagnosed patients of either sex were selected as per JNC 8. The patients with either gender in the age group 18-70 years were included in the study, who were newly diagnosed as per JNC 8, stage I and II of essential hypertension without comorbidities. The patients excluded from the study were the subjects taking hypolipidemic, hypoglycemic, uricosuric drug therapy, subjects administered with combination/multidrug antihypertensive treatment, subjects on chronic drug therapy, taking steroids or estrogen, subjects with any hepatic or renal diseases, pregnant, lactating females, women on contraceptives and subjects with chronic history of smoking and alcoholism.
Twenty-nine newly diagnosed patients with mild to moderate hypertension were enrolled after taking informed and written consent. Before administering losartan, baseline blood pressure and biochemical parameters like lipid profile, serum electrolytes (sodium, potassium and calcium) uric acid, fasting blood sugar level (BSL) were recorded. 12-14 hours of overnight fasting blood sample was taken for laboratory investigation. Mono therapy with losartan (Dose range: 20- 50 mg OD) was started and follow up of measurement of blood pressure was carried out every month. The same biochemical parameters were measured after six months of losartan mono drug therapy. Institutional Ethics Committee Approval was taken prior to the initiation of the study. Study protocol and informed consent forms were also approved by Ethics Committee. Statistical analysis was done using version 20.0 SPSS software. Student’s ‘paired t’ test was applied for statistical analysis of data. The data was expressed as mean ± SD with t- value, p- value, and p< 0.05 was considered as statistically significant.
Results <%
