A 46-year-old woman comes to the physician for a follow-up examination. She had a blood pressure recording of 148/94 mm Hg on her previous visit five weeks ago. Her home blood pressure log shows readings of 151/97 and 146/92 mm Hg in the past week. She has no history of serious illness and takes no medications. She is 160 cm (5 ft 3 in) tall and weighs 52 kg (115 lb); BMI is 20 kg/m2. Her pulse is 88/min and blood pressure is 150/96 mm Hg. Cardiopulmonary examination is unremarkable. Abdominal examination shows no abnormalities. Losartan is now prescribed. When compared with no treatment at all, this patient's current therapy is most likely to result in which of the following changes?

Question

A 46-year-old woman comes to the physician for a follow-up examination. She had a blood pressure recording of 148/94 mm Hg on her previous visit five weeks ago. Her home blood pressure log shows readings of 151/97 and 146/92 mm Hg in the past week. She has no history of serious illness and takes no medications. She is 160 cm (5 ft 3 in) tall and weighs 52 kg (115 lb); BMI is 20 kg/m2. Her pulse is 88/min and blood pressure is 150/96 mm Hg. Cardiopulmonary examination is unremarkable. Abdominal examination shows no abnormalities. Losartan is now prescribed.  When compared with no treatment at all, this patient's current therapy is most likely to result in which of the following changes?

Quizplus · Accepted Answer

Eductional Objective: Angiotensin II receptor blockers (ARBs) work by blocking angiotensin II type 1 receptors, inhibiting the effects of angiotensin II.  This results in arterial vasodilation and decreased aldosterone secretion.  The resulting fall in blood pressure increases renin, angiotensin I, and angiotensin II levels.  ARBs do not affect the activity of angiotensin-converting enzyme, and therefore they do not affect bradykinin degradation and do not cause cough.

A 46-Year-Old Woman Comes to the Physician for a Follow-Up