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

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 p...

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Bibliographic Details
Published in:Clinical and experimental nephrology 2012-04, Vol.16 (2), p.269-278
Main Authors: Hosoya, Tatsuo, Kuriyama, Satoru, Ohno, Iwao, Kawamura, Tetsuya, Ogura, Makoto, Ikeda, Masato, Ishikawa, Masahiro, Hayashi, Fumihiro, Kanai, Tatsuya, Tomonari, Haruo, Soejima, Michimasa, Akaba, Kiyoaki, Tokudome, Goro
Format: Article
Language:English
Subjects:
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
Hypertension - metabolism
Hypertension - physiopathology
Hyperuricemia
Japan
Losartan - therapeutic use
Male
Medicine
Medicine & Public Health
Middle Aged
Natriuretic Peptide, Brain - blood
Nephrology
Original
Original Article
Prospective Studies
Treatment Outcome
Uric Acid - blood
Urology
Young Adult
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Summary: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.
ISSN:1342-1751
1437-7799
DOI:10.1007/s10157-011-0564-4