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Losartan is a small molecule angiotensin II type 1 receptor (AT1R) antagonist originally developed by Merck and marketed as Cozaar for the treatment of hypertension. In a clinical research program led by New York Medical College (notably trial NCT01210430), losartan is being investigated as a repurposed therapy for postural tachycardia syndrome (POTS), often in combination with ascorbic acid (Vitamin C). The therapeutic rationale centers on addressing vascular dysfunction in a subset of POTS patients who exhibit high levels of angiotensin II and low nitric oxide (NO) bioavailability. By blocking AT1R, losartan reduces vasoconstriction and sympathetic overactivity, while the addition of ascorbic acid acts as an antioxidant to restore NO-mediated vasodilation, thereby improving peripheral blood flow regulation.
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