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

被引：7

作者：

Hamada, Toshihiro ^{[1
]}

Kuwabara, Masanari ^{[2
]}

Watanabe, Arisa ^{[1
]}

Mizuta, Einosuke ^{[3
]}

Ohtahara, Akira ^{[3
]}

Omodani, Hiroki ^{[4
]}

Watanabe, Masashi ^{[5
]}

Nakamura, Hiroki ^{[6
]}

Hirota, Yutaka ^{[7
]}

Miyazaki, Satoshi ^{[8
]}

Kato, Masahiko ^{[9
]}

Ogino, Kazuhide ^{[10
]}

Kosaka, Hiroki ^{[11
]}

Haruaki, Ninomiya ^{[12
]}

Taniguchi, Shin-ichi ^{[1
]}

Yamamoto, Kazuhiro ^{[9
]}

Kotake, Hiroshi ^{[13
]}

Hisatome, Ichiro ^{[2
]}

机构：

[1] Tottori Univ, Fac Med, Dept Reg Med, Yonago, Tottori 6838503, Japan

[2] Tottori Univ, Grad Sch Med Sci, Inst Regenerat Med & Biofunct, Div Regenerat Med & Therapeut, Yonago, Tottori 6838503, Japan

[3] Sanin Rosai Hosp, Dept Cardiovasc Med, Yonago, Tottori, Japan

[4] Omodani Clin, Div Cardiovasc Med, Yonago, Tottori, Japan

[5] Watanabe Clin, Div Cardiovasc Med, Sakaiminato, Japan

[6] Nakamura Clin, Tottori, Japan

[7] Tomimasu Surg & Primary Care Clin, Yonago, Tottori, Japan

[8] Nojima Hosp, Div Cardiol, Kurayoshi, Japan

[9] Tottori Univ, Fac Med, Div Mol Med & Therapeut, Yonago, Tottori 6838503, Japan

[10] Tottori Univ Hosp, Ctr Clin Residency Program, Yonago, Tottori, Japan

[11] Tottori Red Cross Hosp, Div Internal Med, Tottori, Japan

[12] Tottori Univ, Fac Med, Dept Biochem Regulat, Yonago, Tottori 6838503, Japan

[13] Kotake Clin, Div Cardiovasc Med, Yonago, Tottori, Japan

来源：

CLINICAL AND EXPERIMENTAL HYPERTENSION | 2014年 / 36卷 / 04期

关键词：

HOMA-R; hydrochlorothiazide; losartan; serum uric acid; telmisartan; URIC-ACID; URATE LEVELS; BENZBROMARONE; COMBINATION; LOSARTAN; THERAPY;

D O I：

10.3109/10641963.2013.810228

中图分类号：

R9 [药学];

学科分类号：

1007 ;

摘要：

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). 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. 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. 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.

引用

页码：251 / 257

页数：7

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