Summertime dosage-dependent hypersensitivity to an angiotensin II receptor blocker

BMC Research Notes

Donald R Forsdyke¹ 

[1] Department of Biomedical and Molecular Sciences, Queen’s University, Kingston K7L3N6, ON, Canada

关键词: J-curve;    Acute kidney injury;    Hypotension;    Losartan;    Angiotensin II receptor;    Environmental temperature;   

Others  :  1232407
DOI  :  10.1186/s13104-015-1215-8

 received in 2014-04-08, accepted in 2015-05-29,  发布年份 2015

【 摘 要 】

Background

Summertime dips in blood pressure (BP), both in normotensive and hypertensive subjects, are well known. However, the dips are small and are not related to particular forms or doses of antihypertensive medication. Nevertheless it is the practice in some quarters to decrease antihypertensive medication in summer, and/or to increase in winter. Large scale studies being inconclusive, there are calls for long-term examination of the relationship between environmental temperature and blood pressure in single individuals under medication.

Case presentation

While analyzing data from a subject whose BP had been controlled for a decade with the angiotensin-II receptor blocker losartan, an extreme, dosage-dependent, summertime dip came to light. Downward dosage adjustment appeared essential and may have prevented hypotension-related pathology.

Conclusion

The benefits of aggressive medication (the “J curve” phenomenon) being debated, the possibility of seasonal hypersensitivity, perhaps explicable in terms of differential signaling by countervailing receptors, should be taken into account when considering dosage adjustments in hypertensive subjects.

【 授权许可】

   
2015 Forsdyke

【 图 表 】

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