Angiotensin converting enzyme inhibitor is known to be effective in the prevention of left ventricular remodeling following myocardial infarction. However, little data is available concerning the clinical effects of angiotensin (AT) receptor blocker in ischemic cardiomyopathy. This study evaluated the clinical effects of the concomitant use of losartan with low doses of hydrochlorthiazide in cases of ischemic cardiomyopathy.

A combined agent of 50 mg of losartan potassium with 12.5 mg of hydrochlorthiazide (HCTZ) was administrated once daily over a 12-week period to 29 patients (M:F=26:3, 61.4±8.7 years) who were diagnosed with ischemic heart failure (ejection fraction lower than 50% by echocardiography) at Chonnam National University Hospital.

Clinical symptoms of dyspnea in the 29 patients improved from 2.08±0.49 to 1.15±0.38 as measured by New York Heart Association class. The systolic and diastolic blood pressure did not change significantly following treatment (116.5±18.0/77.0±11.9 mmHg vs. 118.7±15.1/78.1±11.1 mmHg). The ejection fraction following administration of Losartan/HCTZ increased from 40.3±8.1% to 46.7±10.8% (p=0.001). Losartan/HCTZ was well tolerated in all patients without significant adverse effects or laboratory changes.

A fixed combination of losartan and low dose hydrochlorthiazide is effective in patients with ischemic heart failure.