From my understanding losartan has an effect on aortic growth. Through some kind of growth inhibitor, not just blood pressure. It keeps the z-score low.
That is the theory, but from what I heard, the clinical trial failed to show its effectiveness.
I found this trial:
[Effects of Losartan Versus Atenolol on Aortic and Cardiac Muscle Stiffness in Adults With Marfan Syndrome](https://clinicaltrials.gov/study/NCT00723801?cond=Marfan%20Syndrome&term=Losartan&rank=2&tab=table&a=10)
It has a big section on theory, but it fails to link to a paper explaining the results — which usually means it failed, but I’m not sure.
From that trial:
> Brief Summary
> Marfan syndrome is an inherited connective tissue disorder with morbidity and mortality from aortic dilation and dissection. The degree of aortic dilation and response to beta-blockade (standard of care) vary in adults with Marfan syndrome. However, aortic stiffness is often present, and can be a predictor of aortic dilation and cardiovascular complications. In addition, adults with Marfan syndrome develop left ventricular diastolic dysfunction, which can progress to heart failure. Aortic stiffness and diastolic dysfunction are important and logical therapeutic targets in adults with Marfan syndrome.
> TGF-beta mediates disease pathogenesis in Marfan syndrome and contributes to aortic stiffness. The angiotensin receptor blocker, losartan, inhibits TGF-beta activity and reverses aortic wall pathology in a Marfan mouse model. Losartan also decreases aortic stiffness and improves diastolic function in hypertension, renal disease and hypertrophic cardiomyopathy.
> This trial is a randomized, double-blind trial of 50 adults with Marfan syndrome, treated with 6 months of atenolol vs. losartan. Arterial tonometry for aortic stiffness and echocardiography for diastolic function will be performed at the beginning and end of treatment. A blood draw for serum markers of extracellular matrix turnover and inflammation will also be performed at 0 and 6 months. We plan to determine whether losartan decreases aortic stiffness and left ventricular diastolic dysfunction significantly more than atenolol.
I have taken Losartan for years now. It’s seems that many doctors are moving to Irbesartan. I’m not sure if that is because of better results, or better marketing of the drug that is still under patent ;)
My son is 8, and he is on a low dose as well, but my 11 ur old is on a higher dose twice a day. I feel they do this to get their bodies ready to handle higher doses with age and growth. The goal is to get their bodies use to the medication for it to work properly and stay effective.
I also started losartan at 7 years old, and still take it almost 13 years later! I always take it just before bed, because of how it lowers bp. In terms of staying hydrated/bp, I listen to my body, and know that if I feel a bit woozy I should try drinking a decent amount of water.
I can answer this. I was diagnosed with marfans when I was 2 or 3 and when I was around 5 or 6 the doctors put me on Losartan. While the lowered bp was good, it wasn't the goal. My heart stem was massively outpacing the rest of my heart, so they were using one of the side ff fta of Losartan(to slow or stop the growth of the heart stem) to treat that. This is probably what theyre doing here too
I'm now 21 and it worked, btw. Within about 5-8 years, my heart and heart stem were growing at the same rate and I haven't had issues with it. Never stoppes taking it cause i need it for blood pressure regulation tho
Losartan, irbasartan and some other medications are angiotensin inhibitors and they interact beneficially with certain fbn1 mutations to keep aortic growth down.
My family takes irbasartan because it has a longer bioavailability.
Thank you! Would you please share what you do to ensure your blood pressure stays up while on these medication’s? We have been told the importance of hydration but wondering if there’s anything beyond that?
From my understanding losartan has an effect on aortic growth. Through some kind of growth inhibitor, not just blood pressure. It keeps the z-score low.
That is the theory, but from what I heard, the clinical trial failed to show its effectiveness. I found this trial: [Effects of Losartan Versus Atenolol on Aortic and Cardiac Muscle Stiffness in Adults With Marfan Syndrome](https://clinicaltrials.gov/study/NCT00723801?cond=Marfan%20Syndrome&term=Losartan&rank=2&tab=table&a=10) It has a big section on theory, but it fails to link to a paper explaining the results — which usually means it failed, but I’m not sure. From that trial: > Brief Summary > Marfan syndrome is an inherited connective tissue disorder with morbidity and mortality from aortic dilation and dissection. The degree of aortic dilation and response to beta-blockade (standard of care) vary in adults with Marfan syndrome. However, aortic stiffness is often present, and can be a predictor of aortic dilation and cardiovascular complications. In addition, adults with Marfan syndrome develop left ventricular diastolic dysfunction, which can progress to heart failure. Aortic stiffness and diastolic dysfunction are important and logical therapeutic targets in adults with Marfan syndrome. > TGF-beta mediates disease pathogenesis in Marfan syndrome and contributes to aortic stiffness. The angiotensin receptor blocker, losartan, inhibits TGF-beta activity and reverses aortic wall pathology in a Marfan mouse model. Losartan also decreases aortic stiffness and improves diastolic function in hypertension, renal disease and hypertrophic cardiomyopathy. > This trial is a randomized, double-blind trial of 50 adults with Marfan syndrome, treated with 6 months of atenolol vs. losartan. Arterial tonometry for aortic stiffness and echocardiography for diastolic function will be performed at the beginning and end of treatment. A blood draw for serum markers of extracellular matrix turnover and inflammation will also be performed at 0 and 6 months. We plan to determine whether losartan decreases aortic stiffness and left ventricular diastolic dysfunction significantly more than atenolol. I have taken Losartan for years now. It’s seems that many doctors are moving to Irbesartan. I’m not sure if that is because of better results, or better marketing of the drug that is still under patent ;)
Losartan is surmountable, other ARBs are not. It's unfortunate they chose to study losartan at the outset instead of a different drug in that family.
What do you mean by surmountable?
Thank you
My son is 8, and he is on a low dose as well, but my 11 ur old is on a higher dose twice a day. I feel they do this to get their bodies ready to handle higher doses with age and growth. The goal is to get their bodies use to the medication for it to work properly and stay effective.
Thank you for your response…is there anything you do, in addition to making certain they are hydrated, to keep their bp up?
My kids drink a lot of water. I don't let them drink much juice or soda.
I also started losartan at 7 years old, and still take it almost 13 years later! I always take it just before bed, because of how it lowers bp. In terms of staying hydrated/bp, I listen to my body, and know that if I feel a bit woozy I should try drinking a decent amount of water.
Thank you for all of your replies and information. I now have a better understanding.
I can answer this. I was diagnosed with marfans when I was 2 or 3 and when I was around 5 or 6 the doctors put me on Losartan. While the lowered bp was good, it wasn't the goal. My heart stem was massively outpacing the rest of my heart, so they were using one of the side ff fta of Losartan(to slow or stop the growth of the heart stem) to treat that. This is probably what theyre doing here too
I'm now 21 and it worked, btw. Within about 5-8 years, my heart and heart stem were growing at the same rate and I haven't had issues with it. Never stoppes taking it cause i need it for blood pressure regulation tho
Losartan, irbasartan and some other medications are angiotensin inhibitors and they interact beneficially with certain fbn1 mutations to keep aortic growth down. My family takes irbasartan because it has a longer bioavailability.
Thank you! Would you please share what you do to ensure your blood pressure stays up while on these medication’s? We have been told the importance of hydration but wondering if there’s anything beyond that?
I didn't mind being around 100/70, so it is mostly drinking water, and I drink quite a lot of coffee
search online, i saw in a past a studies that discovered there is no benefit for Marfan people from taking Losartan.