[A new approach to treating secondary pulmonary hypertension].

Objective: to study the clinical and hemodynamic effects and safety of the ACE inhibitor dirotone and AT1-receptor antagonist losartan in secondary pulmonary hypertension (PH) in patients with chronic obstructive bronchitis (COB).

Subjects And Methods: The time course of changes in hemodynamic parameters and diurnal BP profile in 48 patients with COB concurrent with Functional Class (FC) III-IV secondary PH, receiving 4-week therapy including dirotone and losartan.

Results: The inclusion of dirotone or losartan into the combined therapy of patients with secondary pulmonary hypertension resulted in alleviated PH, caused positive changes in the right cardiac cavities, and normalized diurnal BP variables. Therapy with dirotone was effective in COB patients with the clinical signs of FC III PH only during its course use, that with losartan was beneficial in FC III and IV PH. The long-term outpatient use of losartan in individually adjusted doses produced pronounced beneficial clinical effects and led to significantly improved hemodynamic parameters.

Conclusion: The ACE inhibitor dirotone and the AT1-receptor antagonist losartan may be recommended for the correction of hemodynamic disorders in secondary PH in patients with COB.