Meta-analysis of the effect of losartan relative to other angiotensin receptor antagonists on serum uric acid level

Purpose: To systematically analyze the disparity in uric acid reduction between losartan and other angiotensin receptor antagonists. Methods: A computer-based search was conducted in databases including EMBASE, PubMed, Wanfang, CNKI, Ovid MEDLINE, and Web of Science to identify original literature comparing the impact of losartan with other angiotensin receptor antagonists on blood uric acid levels. Utilizing the Cochrane Collaboration bias risk tool, a quality assessment of the included randomized controlled studies was conducted. Results: A total of 12 publications were obtained, consisting of 6 randomized controlled studies and 6 cohort studies. Five of the twelve publications assessed the impact of losartan compared to valsartan on blood uric acid levels. The heterogeneity analysis yielded I-2 = 98 % (p < 0.01), indicating substantial variability among the studies. Findings indicated that losartan was more effective than valsartan in reducing blood uric acid levels (SMD = -3.26, 95 % CI (-5.01 to 1.51), p < 0.05). Four publications investigated the impact of losartan versus telmisartan on blood uric acid levels. The results revealed that losartan had a greater effect in reducing blood uric acid levels compared to telmisartan (SMD = 1.77, 95 % CI (-3.411 to -0.13), p < 0.05). Conclusion: Among the angiotensin receptor antagonists used as antihypertensive drugs, losartan stands out for its significant ability to reduce uric acid levels. This finding provides a strong evidence-base for making clinical medication decisions.