Which is a better treatment for hypertensive patients with diabetes: a combination of losartan and hydrochlorothiazide or a maximum dose of losartan?

This 12-month study compared the effects of a combination of losartan 50 mg and hydrochlorothiazide 12.5 mg with a maximum dose of losartan (100 mg) in hypertensive patients with diabetes.
This was a multicenter randomized open-label study.
A similar reduction in systolic/diastolic blood pressure from baseline to month 3 was observed in both groups. There was also a similar decrease in UACR in both groups. A significant decrease in uric acid was observed in the maximum-dose group only. eGFR decreased in the combination group after 1 year.
The combination of losartan and a diuretic may be a useful option in such hypertensive patients with diabetes, provided that metabolic parameters are closely monitored. In patients with hyperuricemia and impaired renal function, a maximum dose of losartan may be more beneficial.
AuthorsHaruo Nishimura, Mitsuyo Shintani, Koji Maeda, Kentaro Otoshi, Masahiro Fukuda, Joji Okuda, Shigeo Nishi, Shinichiro Ohashi, Sumiko Kato, Yasuto Baba,
JournalClinical and experimental hypertension (New York, N.Y. : 1993) (Clin Exp Hypertens) Vol. 35 Issue 8 Pg. 582-8 ( 2013) ISSN: 1525-6006 [Electronic] England
PMID23496265 (Publication Type: Comparative Study, Journal Article, Multicenter Study, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
Chemical References
  • Antihypertensive Agents
  • Hydrochlorothiazide
  • Uric Acid
  • Losartan
  • Aged
  • Albuminuria (complications)
  • Antihypertensive Agents (therapeutic use)
  • Diabetes Mellitus, Type 2 (complications)
  • Dose-Response Relationship, Drug
  • Drug Therapy, Combination
  • Female
  • Humans
  • Hydrochlorothiazide (therapeutic use)
  • Hypertension (complications, drug therapy)
  • Hyperuricemia (complications)
  • Losartan (therapeutic use)
  • Male
  • Middle Aged
  • Renal Insufficiency, Chronic (complications)
  • Treatment Outcome
  • Uric Acid (blood)

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