Effect of Losartan and Hydrochlorothiazide on Exercise Tolerance in Exertional Hypertension and Left Ventricular Diastolic Dysfunction

William C. Little, Michael R. Zile, Allan Klein, Christopher P. Appleton, Dalane W. Kitzman, Deborah J. Wesley-Farrington

Research output: Contribution to journalArticlepeer-review

38 Scopus citations

Abstract

A randomized, double-blind study of 6 months of losartan 50 mg or hydrochlorothiazide (HCTZ) 12.5 mg was performed in 40 subjects with left ventricular diastolic dysfunction (mitral flow velocity E/A ratio <1), exercise systolic blood pressure (BP) >200 mm Hg, systolic BP at rest <150 mm Hg, ejection fraction >50%, and no ischemia. Before treatment, exercise systolic BP was 213 ± 13 mm Hg (mean ± SD) in the 19 patients randomized to losartan and 209 ± 11 mm Hg in the 21 patients who received HCTZ. After 6 months, exercise systolic BP was similarly reduced in patients who received losartan (197 ± 23 mm Hg, p <0.01) and HCTZ (191 ± 11 mm Hg, p <0.01). With losartan, treadmill exercise time increased from 894 ± 216 to 951 ± 225 seconds (p = 0.011), and quality of life improved from 15 ± 12 to 7 ± 10 (p = 0.015) without a change in oxygen consumption (1,895 ± 470 to 1,954 ± 539 ml/min, p = 0.30). With HCTZ, exercise time (842 ± 225 to 872 ± 239 seconds, p = 0.32) and quality of life (19 ± 21 vs 19 ± 24, p = 0.43) did not change, whereas oxygen consumption decreased from 2,144 ± 788 to 1,960 ± 706 ml/min (p = 0.022). In conclusion, in patients with diastolic dysfunction and hypertensive responses to exercise, 6 months of losartan and HCTZ blunted systolic BP during exercise. Only losartan increased exercise tolerance and improved quality of life.

Original languageEnglish (US)
Pages (from-to)383-385
Number of pages3
JournalAmerican Journal of Cardiology
Volume98
Issue number3
DOIs
StatePublished - Aug 1 2006

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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