Hello everyone, everything good? Today we are going to talk about the most prescribed antihypertensive in Brazil. You must definitely know someone who takes losartan.
Do you take losartan? Leave it here in the comments. Today I'm going to break it down, explain in detail how this medication works, which is so important and so used.
I will explain to you how the medication is absorbed, how it works, how it is eliminated from our body. And, of course, you will know the main side effects of this medication. So stay with me until the end of the video that this video is unmissable!
Without further ado, rotate the vignette. doctor Roberto Yano, Cardiologist. Hello friend of the heart, how are you?
I am Doctor Roberto Yano, Cardiologist, Pacemaker Specialist. Let's talk today about the famous losartan, about the antihypertensive most prescribed by doctors about one of the most prescribed drugs in Brazil, did you know? And why is losartan so prescribed?
Is she that good? First, losartan is a very low-cost drug. She even has it in the popular pharmacy.
Second: it controls blood pressure very well when taken correctly. And third, it has very little side effect. The vast majority of patients do not complain when starting the medication.
But what is the effect of losartan? How does it lower our blood pressure? Losartan is a drug in the class of angiotensin II receptor inhibitors or also called angiotensin II receptor blockers.
The BRAS. It is mainly used in the treatment of high blood pressure. But did you know that it can also be used for heart failure, that is, for those with a weak heart to reduce the risk of a heart attack, the risk of stroke, type II diabetes and the progression of kidney failure.
. . And more, it It can reduce the heart's workload and improve blood flow to the heart muscle.
Didn't you know that? Then leave it here in the comments if you knew it or not. "Doctor, how does it work in our body?
" We know that angiotensin II is a hormone that has several physiological effects. It contracts blood vessels, releases aldosterone, increases sodium and water reabsorption by the kidneys. Losartan works by blocking angiotensin II receptors, thereby lowering blood pressure.
As it is a selective antagonist of the angiotensin II receptor, it acts selectively in blocking these receptors that are in many organs: heart, kidneys, blood vessels, brain. This action of losartan acting on these AT1 receptors leads to a series of beneficial effects. So let's go to the four beneficial effects of losartan.
First effect: lowering blood pressure. Losartan acts as a vasodilator, that is, it will relax your blood vessels, it will help reduce peripheral vascular resistance, which is one of the main factors that contribute to high blood pressure. Second beneficial effect.
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So after the video don't forget to subscribe to the channel. But let's move on to the second benefit: reduction of left ventricular hypertrophy. We know that chronic arterial hypertension can lead to left ventricular hypertrophy, which is an increase in the size of the left ventricular muscle.
So losartan can help reduce left ventricular hypertrophy, especially in hypertensive patients. Or prevent this hypertrophy from happening in patients who have high blood pressure. Third benefit: it decreases water and sodium retention by the body.
Losartan can help reduce water retention, sodium retention by the kidneys, which is also very important to control blood pressure, and avoid fluid overload. And fourth benefit: it improves kidney function. Losartan may help improve kidney function in patients with high blood pressure.
A patient, for example, with type II diabetes and proteinuria, that is, with protein in the urine, it can also help. And what happens after the losartan tablet is ingested? Losartan is absorbed quickly by the intestine, it reaches its maximum effect about an hour after ingestion.
It is metabolized in the liver, has an elimination half-life of about 6 hours, that is, in 6 hours half of it is already metabolized by the body, and its metabolites are excreted by the kidneys. It can indeed be administered once a day, but due to its shorter half-life, many cardiologists prefer to prescribe it every twelve hours, twice a day, and the dose generally does not exceed 100 mg per day. Did you know that Clínica Yano is now here in Indaiatuba?
So you from Indaiatuba, Campinas, São Paulo, this whole region, you can consult with us in person now that we are here in Indaiatuba, SP. But not everything is perfect. Now let's move on to the side effects of losartan.
What are the main side effects? As I said before, it is generally well tolerated, most of the time it does not cause side effects, but in rare cases it can cause dizziness, fatigue, headache, abdominal pain, nausea, diarrhea, sometimes a mild cough, in some cases in rare cases severe allergic reactions, angioedema, anaphylaxis can occur , this is the rarity of the rarity, but I myself have witnessed some cases. It can also be more potent and lower blood pressure in elderly patients, especially those elderly patients who have orthostatic hypotension, what is it?
When there is a drop in blood pressure when standing up. Therefore, it is important for us to carefully monitor blood pressure in elderly patients receiving losartan, this is a special precaution. In patients with advanced stage renal failure, it can also make kidney function even worse and together with that can cause our body's potassium to increase, which we call hyperkalemia.
This hyperkalemia, when not properly treated, can lead to cardiac arrhythmia, disturbances in the electrical conduction of the heart, then look at the danger of self-medication, which I always talk about. You control the pressure, but after a while you start to have arrhythmia, so be careful! Medicine always only with medical prescription.
Let's talk now about the contraindications of losartan. Pregnant women, women who want to become pregnant, should avoid the use of losartan because it can harm the developing fetus. Patients with known hypersensitivity to losartan, or any of the components of the formula should also not use the medication, patients who have bilateral renal artery stenosis, or have stenosis.
. . patients who have only one kidney, generally cannot use this anti -hypertensive.
As I said, patients with liver or kidney failure must be closely monitored to avoid decompensation of these organs. Also remembering that losartan can be used in combination with other antihypertensive drugs, such as diuretics, beta-blockers, aldosterone receptor antagonists, calcium channel blockers, later I will even talk more about these other blood pressure medications . Oh, by the way, which blood pressure medication do you want me to talk about?
Then leave it here in the comments and I'll do a series just about the main high pressure medications. But what about the other BRAS, which is this class of medication? What about the other medications in this class?
Are they better? They are worse? There are other angiotensin II receptor blockers that are similar to losartan in terms of mechanism of action, in terms of therapeutic indication.
Some examples of BRAS are: valsartan, olmesartan, telmisartan, candesartan, in terms of effectiveness in controlling arterial hypertension, these other BRAS showed similar results, with rates of reduction in blood pressure very similar to losartan. So the particular issue in some clinical studies is that losartan it was considered a little less potent than other BRAS such as olmesartan, irbesartan, for example; in terms of lowering systolic blood pressure, especially compared to other ARBs, losartan may have a slightly higher incidence of side effects, such as coughing, dizziness, but overall the ARBs are very similar. There is also a study that compared losartan with valsartan, and valsartan showed a greater reduction in the risk of cardiovascular events in patients with heart failure.
There was another study that also compared some ARBs and they saw that olmesartan was the most potent ARB in terms of reducing blood pressure, both systolic and diastolic. . .
you saw that there are several studies on these drugs. Even Cardiology is an area that is always evolving, and people who are cardiologists have to be always studying to be able to always offer the best treatment, individualized for each patient. So, it is important to point out here in this video that the choice of ARB, of medication, will depend on each patient, always based on individual assessment.
Each case is different. Of course, we always take into account factors such as the clinical condition of the patient, the safety profile of the medication, its effects on blood pressure, this in every blood pressure medication. It is always important to emphasize that the choice and dosage of the medication is always made by a good cardiologist.
So, don't use your neighbor's medication, your husband's. . .
If you have high blood pressure. The first thing you're going to do is schedule an appointment with a good cardiologist. But look guys, how much information!
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A big hug and until next time!