Antihypertensive effect of a fixed-dose combination of losartan/hydrochlorothiazide in patients with uncontrolled hypertension: a multicenter study.

Achieving adequate blood pressure (BP) control often requires more than one antihypertensive agent. The purpose of this study was to determine whether a fixed-dose formulation of losartan (LOS) plus hydrochlorothiazide (HCTZ) (LOS/HCTZ) is effective in achieving a greater BP lowering in patients with uncontrolled hypertension.
The study was a prospective, multicenter, observational trial exploring the antihypertensive effect of a single tablet of LOS 50 mg/HCTZ 12.5 mg. A total of 228 patients whose BP had previously been treated with more than one antihypertensive agents without having achieved BP goal below 130/80 mmHg enrolled in the study.
A significant decrease in systolic and diastolic BP was observed in both clinic and home measurement after switching from the previous treatment to LOS/HCTZ. There was a significant decrease in both B-type natriuretic peptide (BNP) and urinary albumin creatinine (Cr) excretion ratio (ACR), especially in patients with elevated values. In contrast, there was a significant increase in serum Cr concentration in conjunction with a decrease in estimated glomerular filtration rate (eGFR). Overall serum uric acid (UA) concentration increased, whereas in patients with hyperuricemia there was a significant reduction in this value.
Switching to LOS/HCTZ provides a greater reduction in clinic and home BP in patients with uncontrolled hypertension. This combination therapy may lead to cardio-, reno protection and improve UA metabolism.
AuthorsTatsuo Hosoya, Satoru Kuriyama, Iwao Ohno, Tetsuya Kawamura, Makoto Ogura, Masato Ikeda, Masahiro Ishikawa, Fumihiro Hayashi, Tatsuya Kanai, Haruo Tomonari, Michimasa Soejima, Kiyoaki Akaba, Goro Tokudome, S Endo, A Fukui, H Gomi, A Hamaguchi, K Hanaoka, Y Hara, Y Hara, T Hasegawa, H Hayakawa, M Hikida, K Hirano, M Horiguchi, M Hosoya, K Ichida, T Imai, T Ishii, H Ishikawa, C Kameda, T Kasai, A Kobayashi, H Kobayashi, M Kurashige, Y Kusama, H Maezawa, Y Maezawa, Y Maruyama, H Matsuda, N Matsuo, T Matsuo, Y Miura, M Miyajima, M Miyakawa, Y Miyazaki, M Mizuguchi, M Nakao, H Nokano, I Ohkido, Y Ohtsuka, K Okada, H Okamoto, H Okonogi, H Saikawa, H Saito, C Sekiguchi, Y Suetsugu, N Sugano, T Suzuki, T Suzuki, H Takahashi, Y Takahashi, S Takamizawa, K Takane, T Morita, K Takazoe, H Tanaka, S Tanaka, H Terawaki, R Toyoshima, N Tsuboi, T Udagawa, H Ueda, Y Ueda, M Uetake, S Unemura, M Utsunomiya, Y Utsunomiya, T Yamada, Y Yamada, Y Yamaguchi, H Yamamoto, T Yokoo, K Yokoyama, H Yonezawa, H Yoshida, M Yoshida, T Yoshizawa
JournalClinical and experimental nephrology (Clin Exp Nephrol) Vol. 16 Issue 2 Pg. 269-78 (Apr 2012) ISSN: 1437-7799 [Electronic] Japan
PMID22127399 (Publication Type: Journal Article, Multicenter Study, Research Support, Non-U.S. Gov't)
Chemical References
  • Antihypertensive Agents
  • Drug Combinations
  • hydrochlorothiazide, losartan drug combination
  • Hydrochlorothiazide
  • Natriuretic Peptide, Brain
  • Uric Acid
  • Creatinine
  • Losartan
  • Adult
  • Aged
  • Antihypertensive Agents (therapeutic use)
  • Blood Pressure (drug effects)
  • Blood Pressure Determination
  • Creatinine (urine)
  • Drug Combinations
  • Female
  • Glomerular Filtration Rate
  • Humans
  • Hydrochlorothiazide (therapeutic use)
  • Hypertension (drug therapy, metabolism, physiopathology)
  • Hyperuricemia
  • Japan
  • Losartan (therapeutic use)
  • Male
  • Middle Aged
  • Natriuretic Peptide, Brain (blood)
  • Prospective Studies
  • Treatment Outcome
  • Uric Acid (blood)
  • Young Adult

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