A comparative study on the effectiveness of losartan/hydrochlorothiazide and telmisartan/hydrochlorothiazide in patients with hypertension

作者：Hamada Toshihiro^*; Kuwabara Masanari; Watanabe Arisa; Mizuta Einosuke; Ohtahara Akira; Omodani Hiroki; Watanabe Masashi; Nakamura Hiroki; Hirota Yutaka; Miyazaki Satoshi; Kato Masahiko; Ogino Kazuhide; Kosaka Hiroki; Haruaki Ninomiya; Taniguchi Shin ichi; Yamamoto Kazuhiro; Kotake Hiroshi; Hisatome Ichiro

来源：Clinical and Experimental Hypertension, 2014, 36(4): 251-257.

DOI：10.3109/10641963.2013.810228

• HOMA-R
• hydrochlorothiazide
• losartan
• serum uric acid
• telmisartan

Purpose: Long-term effects of a low-dose hydrochlorothiazide (HCTZ) with losartan (LOS) on uric acid (UA) metabolism as well as glucose metabolism have been studied in hypertensive patients in comparison with those of a low-dose HCTZ with telmisartan (TEL). %26lt;br%26gt;Method: Fifty-nine hypertensive patients were allocated to a combination therapy with either losartan (50 mg/day)/HCTZ (12.5 mg/day) (LOS + HCTZ group: n = 37) or telmisartan (40 mg/day)/HCTZ (12.5 mg/day) (TEL + HCTZ group: n = 22), respectively. Before and 1 year after the treatment, blood pressure and biochemical parameters of blood and urine were evaluated. %26lt;br%26gt;Results: Both systolic and diastolic blood pressures significantly decreased in two groups, without any statistical differences among them. LOS + HCTZ caused no changes in the serum UA level or the ratio of UA clearance to creatinine clearance (CUA/Ccr), whereas TEL + HCTZ significantly increased the serum UA level and reduced CUA/Ccr. LOS + HCTZ did not influence CUA/Ccr in patients with their serum UA below 5.4 mg/dl, while LOS + HCTZ significantly increased CUA/Ccr in patients with their serum UA above 5.5 mg/dl. TEL + HCTZ significantly reduced CUA/Ccr in patients with their serum UA below and above 5.4 mg/dl to increase serum UA level significantly. Neither combination therapies caused any changes in fasting plasma glucose, HbA1c and HOMA-R. In patients with their serum UA level above 5.4 mg/dl, TEL + HCTZ increased HOMA-R, whereas LOS + HCTZ did not. %26lt;br%26gt;Conclusions: LOS + HCTZ did not influence UA metabolism as well as glucose metabolism, likely because of inhibitory action of losartan on URAT1, although TEL + HCTZ were accompanied with impairment of the UA metabolism and glucose metabolism.

• 出版日期2014