Introduction: Losartan, an angiotensin receptor blocker (ARB), was patented in 1986¹ and approved for medical use in the United States in 1995. It is primarily prescribed for managing hypertension, but it is also effective in treating diabetic kidney disease, heart failure, and left ventricular hypertrophy. Hypertension is often linked to endothelial dysfunction and elevated cardiovascular risk. Furthermore, hypertension frequently coincides with microalbuminuria, a crucial marker of kidney function.

Microalbuminuria is characterized by albumin excretion levels between 30 and 300 mg/24 hours, or concentrations in spot urine samples between 30 and 300 mg/L². It serves as an important indicator of cardiovascular risk^3,4, with studies suggesting a relationship between high urinary albumin excretion and left ventricular hypertrophy⁵. The antihypertensive effects of Losartan are well-documented, with fewer adverse effects compared to ACE inhibitors⁶, and its potential to reduce microalbuminuria could benefit hypertensive patients significantly.

Objectives: The primary objectives of this study were to evaluate the safety, efficacy, and potential adverse effects of Losartan in reducing microalbuminuria in hypertensive patients.

Significance: The significance of this article lies in its exploration of losartan’s efficacy in reducing microalbuminuria in hypertensive patients, a critical factor in preventing kidney damage and cardiovascular complications. By analyzing losartan’s role in improving renal function, this study contributes to the growing body of evidence supporting angiotensin II receptor blockers (ARBs) in hypertension management. The findings have important clinical implications for early intervention, guiding physicians in optimizing treatment strategies for patients at risk of chronic kidney disease. This research underscores the necessity of targeted antihypertensive therapy in reducing renal complications and improving long-term health outcomes.

Materials and Methods: The study was conducted in outpatient clinics in Rajshahi and Kushtia districts of Bangladesh from July 2023 to June 2024. A total of 36 hypertensive patients (both male and female), aged 40 to 60 years, with microalbuminuria were selected for the study. Patients with severe complications were excluded. After obtaining informed consent, a thorough medical history and physical examination were documented. Spot urine tests were conducted, and patients with microalbuminuria were prescribed 50 mg of Losartan daily for six weeks. After six weeks, the patients were reassessed, and follow-up urine tests were performed to compare results to baseline levels. Six patients were excluded from the study during the follow-up period.

Results: Out of the 30 patients, 20 were male and 10 were female, with a male-to-female ratio of 2:1. The average age of participants was 46.7 years. The majority of patients were employed in services (50%), followed by businesspeople (20%), housewives (20%), and others (10%). The urinary albumin levels before Losartan therapy were µ ± SEM = 100 ± 0.37, while after six weeks of treatment, the levels decreased to µ ± SEM = 77 ± 0.53. This change was statistically significant (P < 0.05).

Table 1: Occupational Distribution of Patients (n=30)

Table 2: Albuminuria Levels Before and After Losartan Therapy (n=30)

Discussion: Several studies have demonstrated that microalbuminuria is a significant predictor of cardiovascular complications^7,8. Our study supports these findings, showing a reduction in albuminuria after Losartan therapy. Similar research has documented the positive effects of Losartan on microalbuminuria, particularly in diabetic patients^9,10,11. Notably, Losartan, as an ARB, is safer compared to ACE inhibitors and offers renoprotective benefits. The reduction in microalbuminuria observed in our hypertensive patient group further emphasizes its potential value in managing both hypertension and kidney function.

Conclusion: Microalbuminuria is an important marker of cardiovascular and renal health in hypertensive individuals. Losartan effectively reduces albuminuria without significant adverse effects, suggesting its therapeutic potential in managing hypertensive patients with microalbuminuria. Further studies with larger sample sizes are needed to confirm these findings and explore the broader clinical applications of Losartan in hypertension and kidney disease management.