title: Comparative effect of angiotensin II type I receptor blockers on serum uric acid in hypertensive patients with type 2 diabetes mellitus: a retrospective observational study.
abstract: BACKGROUND
  Angiotensin II type 1 receptor blockers (ARB) are a frequently used class of antihypertensive drug. The ARB losartan is known to decrease the serum uric acid (SUA) level. However, there are very few clinical data comparing the effects of other ARBs on SUA level under the conditions of clinical practice. This study evaluated and compared the long-term effects of monotherapy with five ARBs on SUA level in Japanese hypertensive patients with type 2 diabetes mellitus (DM).
  
  
  METHODS
  We identified hypertensive patients with type 2 DM who had been treated with monotherapy with losartan (n = 214), valsartan (n = 266), telmisartan (n = 185), candesartan (n = 458), or olmesartan (n = 192), in whom laboratory data of SUA between November 1, 2004 and July 31, 2011 were available, from the Nihon University School of Medicine's Clinical Data Warehouse (NUSM's CDW). We used a propensity-score weighting method and a multivariate regression model to adjust for differences in the background among ARB users, and compared the SUA level. The mean exposure of losartan was 264.7 days, valsartan 245.3 days, telmisartan 235.9 days, candesartan 248.9 days, and olmesartan 234.5 days.
  
  
  RESULTS
  In losartan users, mean SUA level was significantly decreased from baseline, while it was conversely increased in users of other ARBs; valsartan, telmisartan, candesartan, and olmesartan. The mean reduction of SUA level from baseline was significantly greater in losartan users compared with that in other ARB users. Comparison of ARBs other than losartan showed no significant difference in mean change in SUA level from baseline.
  
  
  CONCLUSIONS
  Our study showed that losartan had the most beneficial effect on SUA level among five ARBs, and that there was no significant difference in the unfavorable effects on SUA level among four ARBs other than losartan, at least during one year. These findings provide evidence of an effect of ARBs on SUA level, and support the benefit of the use of losartan in hypertensive patients with type 2 DM.
authors.forename: Yayoi
authors.initials: Y
authors.lastname: Nishida
authors.affiliation: Division of Genomic Epidemiology and Clinical Trials, Clinical Trials Research Center, Nihon University School of Medicine, 30-1 Oyaguchi-Kami Machi, Itabashi-ku, Tokyo 173-8610, Japan. takahashi.yasuo@nihon-u.ac.jp.
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Takahashi
authors.forename: Norio
authors.initials: N
authors.lastname: Susa
authors.forename: Nobukazu
authors.initials: N
authors.lastname: Kanou
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Nakayama
authors.forename: Satoshi
authors.initials: S
authors.lastname: Asai
mesh_terms: D047228:Angiotensin II Type 1 Receptor Blockers / Q000627:therapeutic use*; D001562:Benzimidazoles / Q000627:therapeutic use; D001565:Benzoates / Q000627:therapeutic use; D001713:Biphenyl Compounds / Q000627:therapeutic use; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000150:complications; D005260:Female; D006801:Humans; D006973:Hypertension / Q000097:blood / Q000150:complications / Q000188:drug therapy*; D007093:Imidazoles / Q000627:therapeutic use; D016015:Logistic Models; D019808:Losartan / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D000068557:Olmesartan Medoxomil; D012189:Retrospective Studies; D000077333:Telmisartan; D013777:Tetrazoles / Q000627:therapeutic use; D016896:Treatment Outcome; D014527:Uric Acid / Q000097:blood*; D014633:Valine / Q000031:analogs & derivatives / Q000627:therapeutic use; D000068756:Valsartan
chemical_list: D047228:Angiotensin II Type 1 Receptor Blockers; D001562:Benzimidazoles; D001565:Benzoates; D001713:Biphenyl Compounds; D007093:Imidazoles; D013777:Tetrazoles; D014527:Uric Acid; D000068557:Olmesartan Medoxomil; D000068756:Valsartan; D014633:Valine; D019808:Losartan; C077793:candesartan cilexetil; D000077333:Telmisartan