A comparative study on the effectiveness of losartan/hydrochlorothiazide and telmisartan/hydrochlorothiazide in patients with hypertension. (July 2014)

• Record Type: Journal Article
• Authors: 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
• Is Part Of: Clinical and experimental hypertension. Volume 36:Number 4(2014)
• Page Start: 251
• Page End: 257
• Publication Date: 2014-07
• Subjects: Hypertension -- Chemotherapy -- Periodicals; Hypotensive agents -- Periodicals; 616.132
• DOI: 10.3109/10641963.2013.810228
• Languages: English
• ISSNs: 1064-1963

Abstract

<abstract> <title>Abstract</title> <p> <italic>Purpose:</italic> 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).</p> <p> <italic>Method:</italic> Fifty-nine hypertensive patients were allocated to a combination therapy with either losartan (50 mg/day)/HCTZ (12.5 mg/day) (LOS + HCTZ group: <italic>n</italic> = 37) or telmisartan (40 mg/day)/HCTZ (12.5 mg/day) (TEL + HCTZ group: <italic>n</italic> = 22), respectively. Before and 1 year after the treatment, blood pressure and biochemical parameters of blood and urine were evaluated.</p> <p> <italic>Results:</italic> 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.</p> <p> <italic>Conclusions:</italic> 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.</p> </abstract>