title: A comparative study on the effectiveness of losartan/hydrochlorothiazide and telmisartan/hydrochlorothiazide in patients with hypertension.
abstract: OBJECTIVE
  Long-term effects of a low-dose hydrochlorothiazide (HCTZ) with losartan (LOS) on uric acid (UA) metabolism as well as glucose metabolism have been studied in hypertensive patients in comparison with those of a low-dose HCTZ with telmisartan (TEL).
  
  
  METHODS
  Fifty-nine hypertensive patients were allocated to a combination therapy with either losartan (50 mg/day)/HCTZ (12.5 mg/day) (LOS + HCTZ group: n = 37) or telmisartan (40 mg/day)/HCTZ (12.5 mg/day) (TEL + HCTZ group: n = 22), respectively. Before and 1 year after the treatment, blood pressure and biochemical parameters of blood and urine were evaluated.
  
  
  RESULTS
  Both systolic and diastolic blood pressures significantly decreased in two groups, without any statistical differences among them. LOS + HCTZ caused no changes in the serum UA level or the ratio of UA clearance to creatinine clearance (CUA/Ccr), whereas TEL + HCTZ significantly increased the serum UA level and reduced CUA/Ccr. LOS + HCTZ did not influence CUA/Ccr in patients with their serum UA below 5.4 mg/dl, while LOS + HCTZ significantly increased CUA/Ccr in patients with their serum UA above 5.5 mg/dl. TEL + HCTZ significantly reduced CUA/Ccr in patients with their serum UA below and above 5.4 mg/dl to increase serum UA level significantly. Neither combination therapies caused any changes in fasting plasma glucose, HbA1c and HOMA-R. In patients with their serum UA level above 5.4 mg/dl, TEL + HCTZ increased HOMA-R, whereas LOS + HCTZ did not.
  
  
  CONCLUSIONS
  LOS + HCTZ did not influence UA metabolism as well as glucose metabolism, likely because of inhibitory action of losartan on URAT1, although TEL + HCTZ were accompanied with impairment of the UA metabolism and glucose metabolism.
authors.affiliation: Department of Regional Medicine, Tottori University Faculty of Medicine , Yonago , Japan .
authors.forename: Toshihiro
authors.initials: T
authors.lastname: Hamada
authors.forename: Masanari
authors.initials: M
authors.lastname: Kuwabara
authors.forename: Arisa
authors.initials: A
authors.lastname: Watanabe
authors.forename: Einosuke
authors.initials: E
authors.lastname: Mizuta
authors.forename: Akira
authors.initials: A
authors.lastname: Ohtahara
authors.forename: Hiroki
authors.initials: H
authors.lastname: Omodani
authors.forename: Masashi
authors.initials: M
authors.lastname: Watanabe
authors.forename: Hiroki
authors.initials: H
authors.lastname: Nakamura
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Hirota
authors.forename: Satoshi
authors.initials: S
authors.lastname: Miyazaki
authors.forename: Masahiko
authors.initials: M
authors.lastname: Kato
authors.forename: Kazuhide
authors.initials: K
authors.lastname: Ogino
authors.forename: Hiroki
authors.initials: H
authors.lastname: Kosaka
authors.forename: Ninomiya
authors.initials: N
authors.lastname: Haruaki
authors.forename: Shin-ichi
authors.initials: S
authors.lastname: Taniguchi
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Yamamoto
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Kotake
authors.forename: Ichiro
authors.initials: I
authors.lastname: Hisatome
mesh_terms: D000328:Adult; D000368:Aged; D001562:Benzimidazoles / Q000008:administration & dosage*; D001565:Benzoates / Q000008:administration & dosage*; D001794:Blood Pressure / Q000187:drug effects*; D004305:Dose-Response Relationship, Drug; D004338:Drug Combinations; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006852:Hydrochlorothiazide / Q000008:administration & dosage*; D006973:Hypertension / Q000097:blood / Q000188:drug therapy / Q000503:physiopathology; D019808:Losartan / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D000077333:Telmisartan; D016896:Treatment Outcome; D014527:Uric Acid / Q000097:blood
chemical_list: D001562:Benzimidazoles; D001565:Benzoates; D004338:Drug Combinations; C505809:hydrochlorothiazide, losartan drug combination; C436283:telmisartan, hydrochlorothiazide drug combination; D006852:Hydrochlorothiazide; D014527:Uric Acid; D019808:Losartan; D000077333:Telmisartan
keywords: HOMA-R; hydrochlorothiazide; losartan; serum uric acid; telmisartan