Aldosterone Reduced With Losartan in Hypertension Without Obstructive Sleep Apnea

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Losartan may benefit patients with hypertension and without sleep apnea.
Losartan may benefit patients with hypertension and without sleep apnea.

HealthDay News -- For patients with hypertension and obstructive sleep apnea, treatment with losartan does not lead to significant reductions in aldosterone, but the treatment is tied to aldosterone reductions in patients with hypertension but without obstructive sleep apnea, according to a study published online August 22 in the Annals of the American Thoracic Society.

Erik Thunström, MD, PhD, from the University of Gothenburg in Sweden, and colleagues treated newly diagnosed patients with hypertension and with (54 patients) or without obstructive sleep apnea (35 patients) with losartan daily for 6 weeks. In a second 6-week study, all patients with obstructive sleep apnea continued to receive losartan and were randomly assigned to CPAP or no CPAP. Subjects without obstructive sleep apnea continued to take losartan.

The researchers found that in the first 6-week study losartan significantly increased renin and reduced aldosterone levels in patients without obstructive sleep apnea. Among patients with obstructive sleep apnea there was no significant decrease in aldosterone levels. Add-on CPAP treatment was associated with lower aldosterone levels; reductions were more pronounced in measures of sympathetic activity. After treatment with losartan and CPAP there were no significant changes in inflammatory markers.

"Hypertensive patients with obstructive sleep apnea responded to losartan treatment with smaller reductions in aldosterone compared to hypertensive patients without obstructive sleep apnea," the researchers wrote. "Sympathetic system activity seemed to respond primarily to add-on CPAP treatment in patients with newly-discovered hypertension and obstructive sleep apnea."

Disclosures: The study was partially funded by ResMed Sweden, which supplied some of the CPAP devices.

Reference

  1. Thunström E, Manhem K, Yucel-Linberg T, Rosengren A, Lindberg C, Peker Y. Neuroendocrine and inflammatory responses to losartan and CPAP in patients with hypertension and obstructive sleep apnea: A randomized controlled trial. Ann Am Thorac Soc. 2016. doi:10.1513/AnnalsATS.201602-126OC.
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