Fixed combination of losartan and hydrochlorothiazide and reduction of risk of stroke

Abstract

A fixed-dose combination of losartan/hydrochlorothiazide (HCTZ) therapy may be a logical choice for antihypertensive treatment, including for initial therapy in patients with blood pressure elevation >20/10 mmHg above treatment target. The renin–angiotensin– aldosterone–system-activating effect of hydrochlorothiazide augments the efficacy of blocking the angiotensin II type 1 (AT₁) receptor with losartan. Some adverse effects associated with hydrochlorothiazide, including increased risk for new-onset diabetes mellitus, may be offset by losartan. Losartan was frequently administered with hydrochlorothiazide in the Losartan Intervention For Endpoint reduction in hypertension (LIFE) study, in which there was a 25% risk reduction for stroke in the losartan-based compared with the atenolol-based treatment group. The efficacy, tolerability, and convenience of losartan/HCTZ combination therapy may increase patient compliance and lower risk for stroke, a devastating outcome in patients with hypertension.

Keywords:

• angiotensin receptor blocker
• combination therapy
• hydrochlorothiazide
• hypertension
• stroke