title: Losartan vs. amlodipine treatment in elderly oncologic hypertensive patients: a randomized clinical trial.
abstract: Elderly neoplastic patients frequently may show hypertension and hyperuricemia, before and after chemotherapeutic treatments. The purpose of this study was to evaluate the efficacy of losartan which is an antihypertensive drug with uricosuric properties vs. amlodipine in hypertensive neoplastic elderly patients. This was an open-labeled, randomized, comparative trial. The study was performed as a 30-day study. Seventy patients with cancer were randomly assigned to receive losartan or amlodipine. Blood pressure (BP), blood urea nitrogen (BUN) levels, creatinine, serum and urinary uric acid, creatinine and uric acid clearance were determined before and after chemotherapy. One day after chemotherapy in losartan group vs. amlodipine group we observed a significant difference in urinary uric acid (p<0.001) of 18 mg/24 h vs. 40 mg/24 h. Thirty days after chemotherapy we observed a significant difference in azotemia of 0.0 mg/dl vs. 3.8 mg/dl (p<0.001), serum uric acid of 0.05 mg/dl vs. 0.49 mg/dl (p<0.001), urinary uric acid (p<0.001) of 23 mg/24 h vs. 0.0 mg/24 h, GFR of 2 ml/min/1.73 m(2) vs. -8 ml/min/1.73 m(2) (p<0.05) and systolic BP (SBP) of 3.6 mmHg vs. 0.8 mmHg (p<0.05). The findings of the present study support the effective role of losartan compared to amlodipine in treating hypertension and hyperuricemia in elderly patients under chemotherapeutic treatment.
authors.affiliation: Department of Internal Medicine and Systemic Diseases, University of Catania, Cannizzaro Hospital, Via Messina 829, I-95125 Catania, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Motta
authors.forename: Cristina
authors.initials: C
authors.lastname: Russo
authors.forename: Marco
authors.initials: M
authors.lastname: Vacante
authors.forename: Rocco Luca Emanuele
authors.initials: RL
authors.lastname: Liardo
authors.forename: Francesca
authors.initials: F
authors.lastname: Reitano
authors.forename: Lisa
authors.initials: L
authors.lastname: Cammalleri
authors.forename: Mario
authors.initials: M
authors.lastname: Costanzo
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Benfatto
authors.forename: Paola
authors.initials: P
authors.lastname: Frazzetto
authors.forename: Enrico
authors.initials: E
authors.lastname: Mondati
authors.forename: Michele
authors.initials: M
authors.lastname: Malaguarnera
authors.forename: Giovanni
authors.initials: G
authors.lastname: Pennisi
mesh_terms: D000368:Aged; D017311:Amlodipine / Q000627:therapeutic use*; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D000970:Antineoplastic Agents / Q000627:therapeutic use; D001806:Blood Urea Nitrogen; D003404:Creatinine / Q000097:blood; D005260:Female; D015577:Geriatric Assessment; D005919:Glomerular Filtration Rate / Q000187:drug effects; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000188:drug therapy*; D033461:Hyperuricemia / Q000139:chemically induced / Q000188:drug therapy; D019808:Losartan / Q000627:therapeutic use*; D008297:Male; D009369:Neoplasms / Q000150:complications* / Q000188:drug therapy; D016896:Treatment Outcome; D014527:Uric Acid / Q000097:blood / Q000652:urine
chemical_list: D000959:Antihypertensive Agents; D000970:Antineoplastic Agents; D017311:Amlodipine; D014527:Uric Acid; D003404:Creatinine; D019808:Losartan