Summertime dosage-dependent hypersensitivity to an angiotensin II receptor blocker
- Published
- Accepted
- Subject Areas
- Cardiology
- Keywords
- angiotensin II receptor blocker, environmental temperature, hypotension, acute kidney injury, hypertension, J curve, dosage variation, Losartan, Long-term study, Single individual
- Copyright
- © 2014 Forsdyke
- Licence
- This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
- Cite this article
- 2014. Summertime dosage-dependent hypersensitivity to an angiotensin II receptor blocker. PeerJ PrePrints 2:e144v2 https://doi.org/10.7287/peerj.preprints.144v2
Abstract
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 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. 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 prevent hypotension-related pathology. The benefits of aggressive medication (the “J curve” phenomenon) being debated, the possibility of seasonal hypersensitivity, explicable in terms of differential signaling by countervailing receptors, should be taken into account when considering dosage adjustments in hypertensive subjects.
Author Comment
Version 2 (circa 3000 words, 3 figures) is shorter than Version 1 (circa 5000 words, 8 figures), but the essential message remains unchanged. Those who need more details should go to Version 1.