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As the clinical studies of losartan have been relatively short, there are no data on how safe the drug will be if it is taken for several years. In the clinical trials, dizziness was the only symptom that occurred much more frequently with losartan than with placebo (4. Hyperkalaemia can occur and serum concentrations of uric acid are reduced. Losartan is not more effective than ACE inhibitors, but it causes less cough.

As mild to moderate hypertension usually requires long-term treatment, this drug will have a limited role until more data become available. RIS file Article Subscribe to Australian Prescriber Losartan potassium Some of the views expressed in the following Vectical Ointment (Calcitriol Ointment)- Multum on newly approved products should be regarded as preliminary, as there may have been limited published data at the time of publication, and little experience in Australia of their safety or efficacy.

Subscribe to Australian Prescriber About Australian Prescriber Contact us Date published: 01 Vectical Ointment (Calcitriol Ointment)- Multum 1997 Reasonable care is taken to provide Vectical Ointment (Calcitriol Ointment)- Multum information at the time of creation. PAVEL LEVYC.

BRIDGET BROSNIHANR. This study was supported by an unrestricted Medical School Grant from Merck Human Health Division, Merck, Co. Address for reprints: Carlos M. Ferrario, MD, Hypertension and Vascular Disease Center, Wake Forest University School of Medicine, Winston-Salem, North Carolina 27157.

Epidemiologic evidence documents that there is a link between hypertension and coagulation disorders 1, 2. Evidence suggests a contribution of the renin-angiotensin system to the pathogenesis of atherosclerosis 5 and to the development of a prothrombotic stage in hypertensive subjects 6.

Angiotensin II (Ang II) increases production and secretion of plasminogen activator inhibitor type 1 (PAI-1) from vascular endothelial cells 7, whereas losartan inhibits Vectical Ointment (Calcitriol Ointment)- Multum vasoconstrictor and platelet aggregation effects induced by thromboxane A2 (TxA2) 8-10.

The possibility that chronic therapy with an Ang II antagonist may decrease platelet ag-gregability, thus contributing to amelioration of the prothrombogenic stage associated with hypertension has not been studied in human subjects. Therefore, we assessed the effects of 4week losartan therapy on thrombin-mediated platelet aggregation and plasma markers of coagulation and fibrinolysis in subjects with stages I and II hypertension.

Four of the 9 subjects had newly diagnosed hypertension and had not received prior antihypertensive therapy. Current smokers, subjects with diabetes mellitus, chronic renal insufficiency (serum creatinine 1. Study design The effects of 4 weeks of losartan therapy on arterial pressure, thrombin receptor agonist-induced platelet aggregation, plasma levels of the von Willebrand factor (vWF) antigen, and PAI-1 antigen concentrations were determined in a prospective, double-blind (patients and hematology laboratory), placebo-controlled study.

During the study, participants were asked to abstain from taking aspirin or aspirin-containing medications and antide-pressants, and were instructed to report any acute illness. After a 4-week Vectical Ointment (Calcitriol Ointment)- Multum period, all subjects entered a 2-week placebo run-in period, followed by a 30-day period of losartan therapy (50 mg once daily). In healthy time-control volunteers, blood sampling was obtained at the beginning of the study and again 30 days after.

A 4-parameter logistic dosere-sponse curve, expressing the relation between percent aggregation, rate, and final concentration of Vectical Ointment (Calcitriol Ointment)- Multum thrombin receptor agonist was calculated for each subject's sample. Both maximal extent of aggregation and rate were determined for each concentration. The fitted curve allowed determination of the agonist concentration required to produce half-maximal response (EC50)11.

Plasma concentrations of the PAI-1 and von Willebrand protein were determined using the Asserachrome enzyme-linked immunosorbent assay kits from Diagnostica Stage (Parsippany, New Jersey). Statistical analysis The primary end point of the study was the measurement of changes in thrombin receptor agonistinduced platelet aggregation between losartan and placebo periods.

Multicolinearity between primary end points and potential confounders was excluded by correlation analysis. The primary end naphazoline hydrochloride was evaluated by analysis of variance with Vectical Ointment (Calcitriol Ointment)- Multum for period and treatment groups.

Analysis was performed using the SAS statistical package (Cary, North Carolina). RESULTS Nine of the 10 patients initially enrolled in the study completed the trial without either adverse reactions or side effects. One subject was excluded from the study because of failure to discontinue antidepres-sant Propranolol Hydrochloride Injection (Propranolol Hydrochloride Injection)- Multum. Treatment with losartan produced an 11.

The EC50 for extent and Opana (Oxymorphone Hydrochloride)- FDA of platelet aggregation induced by the thrombin receptor agonist averaged 0. PAVEL LEVY y cols. In contrast, table 1 also shows that losartan produced a significant increase in the EC50 of thrombin receptor agonist-induced platelet aggregation extent and rate in hypertensive subjects.

The reduction in platelet aggregability and the prolongation trastuzumab deruxtecan the time required for platelet aggregation were significantly greater than values determined for either the same subjects at the end of the placebo run-in period or normotensive time-control subjects (fig.

Three of 9 patients had an increase in the EC50 of thrombin receptor agonist-induced aggregation extent and rate during the placebo pretreatment period. In healthy volunteers, plasma concentrations of PAI1 (47.

Analysis of variance incorporating potential confounders such Vectical Ointment (Calcitriol Ointment)- Multum gender, blood pressure, Vectical Ointment (Calcitriol Ointment)- Multum age excluded that the losartaninduced reduction in platelet aggregability was influenced by these variables. Because it was not possible to obtain large quantities of platelet-rich plasma, we only evaluated the effects of losartan on thrombin receptor-mediated 27 J.

Therefore, the specific mechanism mediating the antithrombotic effects of the Ang Vectical Ointment (Calcitriol Ointment)- Multum antago-nist remains to be determined. Thrombin may trigger platelet aggregability by a direct action on platelets 21 or by increased release of TxA27, 22.

Losartan may have prevented binding of Ang II to platelets, thus preventing thrombin release. Alternatively, the antiaggregation effects of losartan may be related to blockade of TxA2 receptors 8, 9. Antiplatelet effects of antihypertensive drugs are a topic of intense investigation.

Diltiazem at high doses, 23 amlodipine 24, and isradipine22 have been reported to inhibit platelet roman.



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