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This combination antihypertensive regimen consists of an angiotensin II receptor blocker (losartan potassium), a thiazide diuretic (hydrochlorothiazide), and a calcium channel blocker (CCB). Losartan works by selectively blocking the binding of angiotensin II to the AT1 receptor, thereby inhibiting vasoconstriction and aldosterone secretion. Hydrochlorothiazide acts on the distal convoluted tubule to inhibit sodium and chloride reabsorption, leading to increased diuresis and a reduction in plasma volume. The calcium channel blocker component (such as amlodipine) inhibits the influx of calcium ions into vascular smooth muscle and cardiac muscle cells, resulting in peripheral vasodilation. This triple-action approach is typically employed in a titration regimen to manage hypertension that is not adequately controlled by monotherapy or dual therapy. The specific regimen was evaluated by Organon and Co in the SAALT (Subtracting Salt and Adding Losartan Trial) to compare its effectiveness when combined with a low-salt DASH diet versus the drug regimen alone.
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