title: Effect of losartan on serum uric acid in hypertension treated with a diuretic: the COMFORT study.
abstract: It has been shown that losartan, an angiotensin II receptor blocker (ARB), reduces serum uric acid levels. However, the effects of losartan on serum uric acid levels in the patients treated with a thiazide diuretic have not been fully elucidated. We have investigated the effects of losartan compared with other ARBs on blood variables and blood pressure control in hypertensive patients treated with a thiazide diuretic using data from the COMFORT study. The present analysis included a total of 118 hypertensive subjects on combination treatment with ARBs except for losartan and a diuretic who were randomly assigned to a daily regimen of a combination pill (losartan 50 mg/hydrochlorothiazide 12.5 mg) or to continuation of two pills, an ARB except for losartan and a diuretic. Blood pressures were evaluated at 1, 3, and 6 months after randomization and changes in blood variables including serum uric acid were evaluated during 6 months treatment period. Mean follow-up blood pressure levels were not different between the combination pill (losartan treatment) group and the control (ARBs except for losartan) group. On the other hand, serum uric acid significantly decreased in the combination pill group compared with the control group (-0.44 versus + 0.10 mg/dl; p = 0.01), although hematocrit, serum creatinine, sodium and potassium were not different between the groups. These results suggest that the treatment regimen switched from a combination therapy of ARBs except for losartan and a diuretic to a combination pill (losartan/ hydrochlorothiazide) decreases serum uric acid without affecting blood pressure control.
authors: Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University , Fukuoka , Japan .
authors: Kiyoshi
authors: K
authors: Matsumura
authors: Hisatomi
authors: H
authors: Arima
authors: Mitsuhiro
authors: M
authors: Tominaga
authors: Toshio
authors: T
authors: Ohtsubo
authors: Toshiyuki
authors: T
authors: Sasaguri
authors: Koji
authors: K
authors: Fujii
authors: Masayo
authors: M
authors: Fukuhara
authors: Keiko
authors: K
authors: Uezono
authors: Yuki
authors: Y
authors: Morinaga
authors: Yuko
authors: Y
authors: Ohta
authors: Takatoshi
authors: T
authors: Otonari
authors: Junya
authors: J
authors: Kawasaki
authors: Isao
authors: I
authors: Kato
authors: Takuya
authors: T
authors: Tsuchihashi
mesh_terms: D000368:Aged; D047228:Angiotensin II Type 1 Receptor Blockers / Q000008:administration & dosage / Q000493:pharmacokinetics; D001794:Blood Pressure / Q000187:drug effects*; D004232:Diuretics / Q000008:administration & dosage / Q000493:pharmacokinetics; D004338:Drug Combinations; D016903:Drug Monitoring / Q000379:methods; D004359:Drug Therapy, Combination / Q000379:methods; D005260:Female; D006801:Humans; D006852:Hydrochlorothiazide / Q000008:administration & dosage / Q000493:pharmacokinetics; D006973:Hypertension / Q000188:drug therapy / Q000378:metabolism / Q000503:physiopathology; D019808:Losartan / Q000008:administration & dosage / Q000493:pharmacokinetics; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome; D014527:Uric Acid / Q000097:blood*
chemical_list: D047228:Angiotensin II Type 1 Receptor Blockers; D004232:Diuretics; D004338:Drug Combinations; D006852:Hydrochlorothiazide; D014527:Uric Acid; D019808:Losartan
keywords: Combination pill; diuretic; hypertension; losartan; uric acid