Losartan vs. amlodipine treatment in elderly oncologic hypertensive patients: a randomized clinical trial.
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.
Motta
Massimo
M
Department of Internal Medicine and Systemic Diseases, University of Catania, Cannizzaro Hospital, Via Messina 829, I-95125 Catania, Italy.
Russo
Cristina
C
Vacante
Marco
M
Liardo
Rocco Luca Emanuele
RL
Reitano
Francesca
F
Cammalleri
Lisa
L
Costanzo
Mario
M
Benfatto
Giuseppe
G
Frazzetto
Paola
P
Mondati
Enrico
E
Malaguarnera
Michele
M
Pennisi
Giovanni
G
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
D000959:Antihypertensive Agents; D000970:Antineoplastic Agents; D017311:Amlodipine; D014527:Uric Acid; D003404:Creatinine; D019808:Losartan