title: Antihypertensive effect of a fixed-dose combination of losartan/hydrochlorothiazide in patients with uncontrolled hypertension: a multicenter study.
abstract: 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.
  
  
  CONCLUSIONS
  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.
authors: Department of Kidney and Hypertension, Jikei University School of Medicine, Tokyo, Japan.
authors: Tatsuo
authors: T
authors: Hosoya
authors: Satoru
authors: S
authors: Kuriyama
authors: Iwao
authors: I
authors: Ohno
authors: Tetsuya
authors: T
authors: Kawamura
authors: Makoto
authors: M
authors: Ogura
authors: Masato
authors: M
authors: Ikeda
authors: Masahiro
authors: M
authors: Ishikawa
authors: Fumihiro
authors: F
authors: Hayashi
authors: Tatsuya
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authors: Kanai
authors: Haruo
authors: H
authors: Tomonari
authors: Michimasa
authors: M
authors: Soejima
authors: Kiyoaki
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authors: Akaba
authors: Goro
authors: G
authors: Tokudome
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authors: S
authors: Endo
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authors: Fukui
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authors: Gomi
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authors: Hamaguchi
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authors: K
authors: Hanaoka
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authors: Hara
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authors: Hara
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authors: T
authors: Hasegawa
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authors: Hayakawa
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authors: Hikida
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authors: Hirano
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authors: M
authors: Horiguchi
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authors: Hosoya
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authors: K
authors: Ichida
authors: T
authors: T
authors: Imai
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authors: T
authors: Ishii
authors: H
authors: H
authors: Ishikawa
authors: C
authors: C
authors: Kameda
authors: T
authors: T
authors: Kasai
authors: A
authors: A
authors: Kobayashi
authors: H
authors: H
authors: Kobayashi
authors: M
authors: M
authors: Kurashige
authors: Y
authors: Y
authors: Kusama
authors: H
authors: H
authors: Maezawa
authors: Y
authors: Y
authors: Maezawa
authors: Y
authors: Y
authors: Maruyama
authors: H
authors: H
authors: Matsuda
authors: N
authors: N
authors: Matsuo
authors: T
authors: T
authors: Matsuo
authors: Y
authors: Y
authors: Miura
authors: M
authors: M
authors: Miyajima
authors: M
authors: M
authors: Miyakawa
authors: Y
authors: Y
authors: Miyazaki
authors: M
authors: M
authors: Mizuguchi
authors: M
authors: M
authors: Nakao
authors: H
authors: H
authors: Nokano
authors: I
authors: I
authors: Ohkido
authors: Y
authors: Y
authors: Ohtsuka
authors: K
authors: K
authors: Okada
authors: H
authors: H
authors: Okamoto
authors: H
authors: H
authors: Okonogi
authors: H
authors: H
authors: Saikawa
authors: H
authors: H
authors: Saito
authors: C
authors: C
authors: Sekiguchi
authors: Y
authors: Y
authors: Suetsugu
authors: N
authors: N
authors: Sugano
authors: T
authors: T
authors: Suzuki
authors: T
authors: T
authors: Suzuki
authors: H
authors: H
authors: Takahashi
authors: Y
authors: Y
authors: Takahashi
authors: S
authors: S
authors: Takamizawa
authors: K
authors: K
authors: Takane
authors: T
authors: T
authors: Morita
authors: K
authors: K
authors: Takazoe
authors: H
authors: H
authors: Tanaka
authors: S
authors: S
authors: Tanaka
authors: H
authors: H
authors: Terawaki
authors: R
authors: R
authors: Toyoshima
authors: N
authors: N
authors: Tsuboi
authors: T
authors: T
authors: Udagawa
authors: H
authors: H
authors: Ueda
authors: Y
authors: Y
authors: Ueda
authors: M
authors: M
authors: Uetake
authors: S
authors: S
authors: Unemura
authors: M
authors: M
authors: Utsunomiya
authors: Y
authors: Y
authors: Utsunomiya
authors: T
authors: T
authors: Yamada
authors: Y
authors: Y
authors: Yamada
authors: Y
authors: Y
authors: Yamaguchi
authors: H
authors: H
authors: Yamamoto
authors: T
authors: T
authors: Yokoo
authors: K
authors: K
authors: Yokoyama
authors: H
authors: H
authors: Yonezawa
authors: H
authors: H
authors: Yoshida
authors: M
authors: M
authors: Yoshida
authors: T
authors: T
authors: Yoshizawa
mesh_terms: D000328:Adult; D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects*; D001795:Blood Pressure Determination; D003404:Creatinine / Q000652:urine; D004338:Drug Combinations; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D006852:Hydrochlorothiazide / Q000627:therapeutic use*; D006973:Hypertension / Q000188:drug therapy* / Q000378:metabolism / Q000503:physiopathology; D033461:Hyperuricemia; D007564:Japan; D019808:Losartan / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood; D011446:Prospective Studies; D016896:Treatment Outcome; D014527:Uric Acid / Q000097:blood; D055815:Young Adult
chemical_list: D000959:Antihypertensive Agents; D004338:Drug Combinations; C505809:hydrochlorothiazide, losartan drug combination; D006852:Hydrochlorothiazide; D020097:Natriuretic Peptide, Brain; D014527:Uric Acid; D003404:Creatinine; D019808:Losartan