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

Abstract

BACKGROUND:

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.

METHODS:

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.

RESULTS:

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.

CONCLUSION:

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.

• Authors: Tatsuo 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
• Journal: Clinical and experimental nephrology (Clin Exp Nephrol) Vol. 16 Issue 2 Pg. 269-78 (Apr 2012) ISSN: 1437-7799 [Electronic] Japan
• PMID: 22127399 (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

Topics

• 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