Re: cozaar side effect

Posted By Kathy on February 01, 1999 at 21:02:08:

In Reply to: Re: cozaar side effect posted by CCF CARDIO MD - CRC on February 01, 1999 at 11:07:31:






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.
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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.
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Thanks Dr.CARDIO,  I was only diagnosed with hypertension 12/97 and
was on Zestril for 2 months.  I was coughing like crazy before switching
to Cozaar/50mg.  I also had sick Sinus syndrome (slow heart beat 30s, 40s
and 50s).  I am a power walker (4 miles during lunch hour) at least
3 times a week.  I was a little surprise when my stress test came up
abnormal 2 weeks ago.  I'll be seeing my cardiology this thursday.
Since January, I started juicing (lots of veges and fruits) and I am
also on a chinese herb called Danshen.  I don't know which helps but
my heartbeat stablizes at 50s now and blood pressure is 125/75 up and
down a few points.  I have stopped cozaar/25 mg 2 days ago.  I just
don't understand the thickening of heart wall.  What is the impact
of this thickening - how dangerous?  Can this be reversed?  I'll also
find out more on thursday.  Thanks again, doc.
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.