title: One-year effectiveness and safety of open-label losartan/hydrochlorothiazide combination therapy in Japanese patients with hypertension uncontrolled with ARBs or ACE inhibitors.
abstract: The long-term antihypertensive efficacy and safety of losartan/hydrochlorothiazide (HCTZ) combinations have not been appropriately evaluated in Japan. In this study, treated hypertensive patients taking angiotensin-receptor blocker (ARB) or angiotensin-converting enzyme inhibitor (ACEI) regimens not at blood pressure (BP) goals proposed by the Japanese Society of Hypertension (JSH) were switched to losartan/HCTZ combinations and followed for 1 year. Data analysis included 244 patients aged 64.5+/-10.7 years, 56% male, 27% with diabetes mellitus and 36% with dyslipidemia. Pre-switching BP 157+/-16/88+/-10 mm Hg promptly decreased and maintained a steady state, reaching 132+/-15/77+/-9 mm Hg (P<0.001) 1 year later. After 1 year of treatment, 50% of patients cleared the goals of the JSH guideline for systolic BP and 79% for diastolic BP. Patients with maximal doses of ARBs tended to show larger decreases in BP (159+/-11/90+/-10 to 128+/-10/75+/-8 mm Hg, P<0.001, n=32). Clinical and laboratory adverse events were reported for 29 patients (11%), but serious abnormalities were not observed. In particular, plasma levels of uric acid (UA) were well-maintained for 1 year, and significant decreases in UA were observed in patients with higher levels of UA (>/=7.0 mg dl(-1)). Losartan/HCTZ combinations showed strong and steady hypotensive abilities and acceptable safety and tolerability in patients currently not at BP goals with regimens including ARBs or ACEIs in Japan.
authors.affiliation: Faculty of Medicine, Department of Internal Medicine, Division of Circulatory and Body Fluid Regulation, University of Miyazaki, Miyazaki, Japan. kita@po.sphere.ne.jp
authors.forename: Toshihiro
authors.initials: T
authors.lastname: Kita
authors.forename: Naoto
authors.initials: N
authors.lastname: Yokota
authors.forename: Yoshinari
authors.initials: Y
authors.lastname: Ichiki
authors.forename: Takao
authors.initials: T
authors.lastname: Ayabe
authors.forename: Takuma
authors.initials: T
authors.lastname: Etoh
authors.forename: Noboru
authors.initials: N
authors.lastname: Tamaki
authors.forename: Johji
authors.initials: J
authors.lastname: Kato
authors.forename: Tanenao
authors.initials: T
authors.lastname: Eto
authors.forename: Kazuo
authors.initials: K
authors.lastname: Kitamura
mesh_terms: D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D044466:Asian People; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D006852:Hydrochlorothiazide / Q000627:therapeutic use*; D006973:Hypertension / Q000188:drug therapy*; D007564:Japan; D019808:Losartan / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged
chemical_list: D000959:Antihypertensive Agents; D006852:Hydrochlorothiazide; D019808:Losartan