Losartan Has No Effect on High Altitude Diuresis or Acute Mountain Sickness in Well-Acclimatizing Individuals

Delamere John P.; Bradwell Susie B.; Lewis Christopher T.; Clarke Alex; Bradwell Arthur R.

摘要

Delamere, John P., Susie B. Bradwell, Christopher T. Lewis, Alex Clarke, and Arthur R. Bradwell. Losartan has no effect on high altitude diuresis or acute mountain sickness in well-acclimatizing individuals. High Alt Med Biol. 22:96-101, 2021.Introduction: The diuretic response that occurs on ascent to altitude is associated with suppression of aldosterone. We speculated that losartan, an angiotensin II receptor blocker, might further reduce aldosterone activity thereby enhancing the diuresis.Materials and Methods: Twenty subjects (paired for angiotensin converting enzyme genotypes [II:ID:DD] gender and age) were randomized, on a double-blind basis, to either daily losartan, 100 mg, or placebo. During 7 days of motorized ascent from 2,850 to 5,035 m, collections of 24-hour urine output were measured daily with samples taken for sodium (Na+) and potassium (K+) concentrations. In addition, measurements were made of blood gases and aldosterone concentrations.Results: During the main ascent, there were similar progressive increases in 24-hour urine volumes in placebo and losartan groups with no change in Na+ or K+ excretion. There were negative correlations between mean 24-hour urine volumes and PaO2 (r = -0.97, p 0.03), and the diuretic response and acute mountain sickness scores at 5,053 m (r = -0.51, p 0.03). There were no significant changes in aldosterone concentrations measured at baseline and at our high point on day 6 within or between the losartan and placebo groups.Conclusion: The high altitude diuretic response was not increased by losartan indicating aldosterone activity was suppressed in individuals on placebo who were acclimatizing well to altitude.

机译：德拉米尔，约翰·P·苏西B.布拉德韦尔，克里斯托弗·T.刘易斯，亚历克斯·克拉克和亚瑟R.布拉德韦尔。氯沙坦有良好的适应环境的个体在高海拔利尿或急性高原病没有影响。高Alt Med Biol。 22：96-101，2021.Introduction：上上升到高度与醛固酮的抑制相关时出现利尿反应。我们推测，氯沙坦，血管紧张素II受体阻滞剂，可能会进一步降低醛固酮活性，从而增强了diuresis.Materials和方法：将24名受试者（配对为血管紧张素转换酶基因型[II：ID：DD]性别和年龄），随机，上双盲的基础上，要么每日氯沙坦，100毫克，或安慰剂。在7天期间机动上升的从2850到5035米，用采取钠（Na +）和钾（K +）浓度的样品每天测量24小时尿量的集合。此外，测量了血液气体和醛固酮concentrations.Results的：在主上升，有类似的逐步增加在24小时尿液体积在安慰剂和与Na +或K +排泄无变化氯沙坦组。有平均24小时尿量和氧分压（R = -0.97，p <0.03），和利尿反应和急性高山病得分之间的负相关性在5053米性（r = -0.51，p <0.03）。有在基线和内或氯沙坦和安慰剂groups.Conclusion之间的第6天，我们的高点测量醛固酮浓度没有显著变化：指示醛固酮活性高海拔利尿反应并没有增加氯沙坦对安慰剂的个体被镇压谁被驯化以及海拔高度。

Losartan Has No Effect on High Altitude Diuresis or Acute Mountain Sickness in Well-Acclimatizing Individuals

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