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

• Published in: Clinical and experimental hypertension (1993) Vol. 36; no. 4; pp. 251 - 257
• Main Authors: Hamada, Toshihiro, Kuwabara, Masanari, Watanabe, Arisa, Mizuta, Einosuke, Ohtahara, Akira, Omodani, Hiroki, Watanabe, Masashi, Nakamura, Hiroki, Hirota, Yutaka, Miyazaki, Satoshi, Kato, Masahiko, Ogino, Kazuhide, Kosaka, Hiroki, Haruaki, Ninomiya, Taniguchi, Shin-ichi, Yamamoto, Kazuhiro, Kotake, Hiroshi, Hisatome, Ichiro
• Format: Journal Article
• Language: English
• Published: England Informa Healthcare USA, Inc 01.01.2014; Taylor & Francis
• Subjects: Adult; Aged; Benzimidazoles - administration & dosage; Benzoates - administration & dosage; Blood Pressure - drug effects; Dose-Response Relationship, Drug; Drug Combinations; Female; Follow-Up Studies; HOMA-R; Humans; hydrochlorothiazide; Hydrochlorothiazide - administration & dosage; Hypertension - blood; Hypertension - drug therapy; Hypertension - physiopathology; losartan; Losartan - administration & dosage; Male; Middle Aged; Prospective Studies; serum uric acid; telmisartan; Treatment Outcome; Uric Acid - blood; HOMA-R; serum uric acid; losartan; telmisartan; hydrochlorothiazide
• ISSN: 1064-1963; 1525-6006
• DOI: 10.3109/10641963.2013.810228

Abstract 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.