Hypertension Meds Safe for Heart Failure

Cozaar and Atacand do not increase mortality among heart failure patients

/ Author:  / Reviewed by: Joseph V. Madia, MD

(RxWiki News) Previous studies have suggested that the hypertension drug losartan could lower survival among heart failure patients. However, new research suggests high doses of Cozaar (losartan) does not contribute to an increased risk of dying.

During the study, researchers compared losartan to Atacand (candesartan), a blood pressure medication that belongs to the same class of drugs (angiotensin II receptor blockers [ARBs]).

"Ask your pharmacist about the risks of particular medications."

Henrik Svanstrom, M.Sc., of Statens Serum Institut in Denmark, noted in the study that researchers found no significantly increased mortality risk for heart failure patients taking high dose losartan. They found that patients taking lower doses of the drug could be at an increased risk of dying.

Researchers identified 2,082 patients taking candesartan and 4,397 losartan users from a nationwide Danish registry. Patients were at least 45 years old with a first-time hospitalization for heart failure between 1998 and 2000. During the follow up period, 330 patients taking candesartan died, while 1,212 of those taking losartan died.

The researchers determined there was no increased risk of dying among patients taking a high dose of losartan, defined as 100 milligrams, as compared to a high dose of candesartan.

However, they did find that low dose losartan, 12.5 milligrams, was linked to a two fold increased risk of mortality compared to high doses of cadesartan, or between 16 and 32 milligrams. Patients taking a medium dose of losartan, or 50 milligrams, also were discovered to be at an added risk of dying.

Investigators said the findings suggest that the risk of death for heart failure patients taking losartan increases as the dose decreases. Researchers noted that as compared to previous observational studies, the new data provides "a more detailed insight into the complexity of the association between losartan use and mortality risk in heart failure."

The study was recently published in the Journal of the American Medical Association.

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Review Date: 
April 12, 2012
Last Updated:
April 13, 2012