title: Which is a better treatment for hypertensive patients with diabetes: a combination of losartan and hydrochlorothiazide or a maximum dose of losartan?
abstract: BACKGROUND
  This 12-month study compared the effects of a combination of losartan 50 mg and hydrochlorothiazide 12.5 mg with a maximum dose of losartan (100 mg) in hypertensive patients with diabetes.
  
  
  METHODS
  This was a multicenter randomized open-label study.
  
  
  RESULTS
  A similar reduction in systolic/diastolic blood pressure from baseline to month 3 was observed in both groups. There was also a similar decrease in UACR in both groups. A significant decrease in uric acid was observed in the maximum-dose group only. eGFR decreased in the combination group after 1 year.
  
  
  CONCLUSIONS
  The combination of losartan and a diuretic may be a useful option in such hypertensive patients with diabetes, provided that metabolic parameters are closely monitored. In patients with hyperuricemia and impaired renal function, a maximum dose of losartan may be more beneficial.
authors.affiliation: Division of Diabetes and Endocrinology, Osaka Saiseikai Nakatsu Hospital , Osaka , Japan.
authors.forename: Haruo
authors.initials: H
authors.lastname: Nishimura
authors.forename: Mitsuyo
authors.initials: M
authors.lastname: Shintani
authors.forename: Koji
authors.initials: K
authors.lastname: Maeda
authors.forename: Kentaro
authors.initials: K
authors.lastname: Otoshi
authors.forename: Masahiro
authors.initials: M
authors.lastname: Fukuda
authors.forename: Joji
authors.initials: J
authors.lastname: Okuda
authors.forename: Shigeo
authors.initials: S
authors.lastname: Nishi
authors.forename: Shinichiro
authors.initials: S
authors.lastname: Ohashi
authors.forename: Sumiko
authors.initials: S
authors.lastname: Kato
authors.forename: Yasuto
authors.initials: Y
authors.lastname: Baba
mesh_terms: D000368:Aged; D000419:Albuminuria / Q000150:complications; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D004305:Dose-Response Relationship, Drug; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D006852:Hydrochlorothiazide / Q000627:therapeutic use*; D006973:Hypertension / Q000150:complications / Q000188:drug therapy*; D033461:Hyperuricemia / Q000150:complications; D019808:Losartan / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D051436:Renal Insufficiency, Chronic / Q000150:complications; D016896:Treatment Outcome; D014527:Uric Acid / Q000097:blood
chemical_list: D000959:Antihypertensive Agents; D006852:Hydrochlorothiazide; D014527:Uric Acid; D019808:Losartan