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Heart Disease (Expert Forum)
Re: cozaar side effect
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Re: cozaar side effect
by Cleveland Clinic, MD, Jan 01, 1995 12:00AM
, Jan 01, 1995 12:00AM
Posted By CCF CARDIO MD - CRC on February 01, 1999 at 11:07:31:
In Reply to: cozaar side effect posted by Kathy on January 30, 1999 at 16:53:29:
I had been taking cozaar 50 mg for a year. I just swtich to 25 mg.
I searched the archieve for cozaar and somebody was asking about cozaar
was causing increase in left ventricular wall thickness. The msg was
3/24/98. I just had an EKG and Stress test and I seemed to develop
thickness in the left ventricular wall. I'll need to see my doctor
next week. I read up a lot on side effects on cozzar and none
mentioned this thickening of the left ventricular wall. Would
appreciate any comment on this and the patients that are taking this
medicine. Thanks.
--------------------------------------------------------------------------------------------------------------------
Dear Kathy,
Thank you for your question. I have posted a copy of the previous reply below. Cozaar will not increase wall thickness. The main cause of increased wall thickness is long standing hypertension. Many people who take Cozaar have a history of hypertension. Thus there is an association but not causality. Hope this clears things up.
Cozaar is known as an Angiotensin II Receptor Blocker (A-II) and Zestril is an Angiotension Converting Enzyme Inhibitor (ACE-I). We have very good information from many clinical studies that ACE-I improve survival and clinical symptoms of heart failure in patients with congestive heart failure. ACE-I work by blocking the enzyme (ACE) that converts angiotensin to angiotensin II which is a powerful constrictor of blood vessels and also block the breakdown of bradykinins which is what causes the cough you describe. A-II works by blocking the receptor for angiotensin II but don't have any effect on bradykinins. We have no good data on A-II in CHF yet but trials are ongoing now. Thus, we recommend that all patients with CHF or a reduced E.F. be treated with ACE-I if they tolerate the side effects. If not, then Cozaar is a good alternative at this time. Neither ACE-I nor A-II should increase your LV wall thickness. Both agents also decrease blood pressure which would reduce LV wall thickness as BP is controlled. E.F. is a relative assessment of left ventricular function since the tests that measure E.F. are not highly accurate so we view E.F. as more of an estimate than a hard fact. However, it sounds reasonable to stop your lanoxin.
If you are not symptomatic at this time (i.e. - no shortness of breath, no fatigue) then mild-moderate exercise would be very beneficial to you. However, you should consult your physician before embarking on an exercise program.
I hope you find this information useful. Information provided in the heart forum is for general purposes only. Only your physician can provide specific diagnoses and therapies. Please feel free to write back with additional questions.
If you would like to make an appointment at the Cleveland Clinic Heart Center, please call 1-800-CCF-CARE or inquire online by using the Heart Center website at www.ccf.org/heartcenter. The Heart Center website contains a directory of the cardiology staff that can be used to select the physician best suited to address your cardiac problem.
In Reply to: cozaar side effect posted by Kathy on January 30, 1999 at 16:53:29:
I had been taking cozaar 50 mg for a year. I just swtich to 25 mg.
I searched the archieve for cozaar and somebody was asking about cozaar
was causing increase in left ventricular wall thickness. The msg was
3/24/98. I just had an EKG and Stress test and I seemed to develop
thickness in the left ventricular wall. I'll need to see my doctor
next week. I read up a lot on side effects on cozzar and none
mentioned this thickening of the left ventricular wall. Would
appreciate any comment on this and the patients that are taking this
medicine. Thanks.
--------------------------------------------------------------------------------------------------------------------
Dear Kathy,
Thank you for your question. I have posted a copy of the previous reply below. Cozaar will not increase wall thickness. The main cause of increased wall thickness is long standing hypertension. Many people who take Cozaar have a history of hypertension. Thus there is an association but not causality. Hope this clears things up.
Cozaar is known as an Angiotensin II Receptor Blocker (A-II) and Zestril is an Angiotension Converting Enzyme Inhibitor (ACE-I). We have very good information from many clinical studies that ACE-I improve survival and clinical symptoms of heart failure in patients with congestive heart failure. ACE-I work by blocking the enzyme (ACE) that converts angiotensin to angiotensin II which is a powerful constrictor of blood vessels and also block the breakdown of bradykinins which is what causes the cough you describe. A-II works by blocking the receptor for angiotensin II but don't have any effect on bradykinins. We have no good data on A-II in CHF yet but trials are ongoing now. Thus, we recommend that all patients with CHF or a reduced E.F. be treated with ACE-I if they tolerate the side effects. If not, then Cozaar is a good alternative at this time. Neither ACE-I nor A-II should increase your LV wall thickness. Both agents also decrease blood pressure which would reduce LV wall thickness as BP is controlled. E.F. is a relative assessment of left ventricular function since the tests that measure E.F. are not highly accurate so we view E.F. as more of an estimate than a hard fact. However, it sounds reasonable to stop your lanoxin.
If you are not symptomatic at this time (i.e. - no shortness of breath, no fatigue) then mild-moderate exercise would be very beneficial to you. However, you should consult your physician before embarking on an exercise program.
I hope you find this information useful. Information provided in the heart forum is for general purposes only. Only your physician can provide specific diagnoses and therapies. Please feel free to write back with additional questions.
If you would like to make an appointment at the Cleveland Clinic Heart Center, please call 1-800-CCF-CARE or inquire online by using the Heart Center website at www.ccf.org/heartcenter. The Heart Center website contains a directory of the cardiology staff that can be used to select the physician best suited to address your cardiac problem.
