The antiarrhythmic potential of angiotensin II antagonism: experience with losartan

• Published in: American journal of hypertension Vol. 13; no. 5; pp. 512 - 517
• Main Authors: Gavras, Irene, Gavras, Haralambos
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.05.2000; Oxford University Press; Elsevier Science
• Subjects: angiotensin II; Angiotensin Receptor Antagonists; angiotensin-converting enzyme inhibitors; Anti-Arrhythmia Agents - therapeutic use; Antiarrhythmics; arrhythmias; Arrhythmias, Cardiac - drug therapy; Arrhythmias, Cardiac - mortality; Biological and medical sciences; Cardiovascular system; Death, Sudden, Cardiac - prevention & control; Heart Rate - drug effects; Humans; Losartan; Losartan - therapeutic use; Medical sciences; Pharmacology. Drug treatments; Receptor, Angiotensin, Type 1; Receptor, Angiotensin, Type 2; Survival Rate; Vasodilator agents. Cerebral vasodilators; angiotensin-converting enzyme inhibitors; arrhythmias; Losartan; angiotensin II; Human; Heart failure; Prognosis; Vasodilator agent; Enzyme; Captopril; Enzyme inhibitor; Cardiovascular disease; Antiarrhythmic agent; Survival; Peptidases; Chemotherapy; Treatment; Follow up study; Peptidyl-dipeptidase A; Heart disease; Hydrolases; Peptidyl-dipeptidases; Angiotensin antagonist; Mechanism of action; Comparative study
• ISSN: 0895-7061; 1879-1905; 1941-7225
• DOI: 10.1016/S0895-7061(99)00277-0

A large body of literature accumulated over the past several years supports the notion that inhibition of the renin-angiotensin system protects the heart and other target organs from hypertensive complications. Various studies have shown that angiotensin-converting enzyme inhibitors reduce morbidity and mortality in the setting of ischemic heart disease and/or congestive heart failure. The improvement in survival has been attributed in part to a significant decrease in the incidence of sudden deaths, possibly due to a decrease in complex arrhythmia episodes. Recently, the angiotensin II type 1 receptor antagonist losartan was shown to reduce mortality by 46% compared with captopril in older patients with chronic congestive heart failure. This paper briefly reviews the arrhythmogenic properties of angiotensin II and the possible pharmacologic mechanisms for the antiarrhythmogenic potential of losartan.