title: Effect of losartan combined with amlodipine or with a thiazide on uric acid levels in hypertensive patients.
abstract: Hyperuricemia leads to endothelial dysfunction and insulin resistance, and has been associated with diseases such as hypertension. Antihypertensive drugs modify serum uric acid levels, however, few data are available about their combinations on uricemia. In this study we evaluate the effect of two combinations of losartan, with amlodipine or with hydrochlorothiazide, on serum uric acid levels in hypertensive patients.
  
  
  METHODS
  A total of 60 hypertensive patients were randomized in two groups; group LA received losartan/amlodipine (100/5 mg) once a day, whereas LH group received losartan hydrochlorothiazide (100/12.5 mg) once a day for 3 months. In both groups serum uric acid levels were measured at the beginning and end of the study. Patients were evaluated monthly for blood pressure (BP) and adverse events. Statistical analysis was performed with a two-way analysis of variance (ANOVA) for repeated measures.
  
  
  RESULTS
  All patients experienced a significant reduction of BP to the same extent (LA 155/94 to 123/79, LH 157/92 to 124/78 mmHg, p > 0.05). In the LA group, serum uric acid decreased from 6.5 ± 1.6 to 4.6 ± 1.3 mg/ml ( p = 0.0001), whereas in the LH group there was a nonsignificant increase from 5.82 ± 1.4 to 5.85 ± 1.5 mg/ml, ( p = 0.936). When both groups were compared, we found a significant reduction ( p < 0.00013) on serum uric acid levels in the LA group.
  
  
  CONCLUSIONS
  Both combinations decrease BP values to the same extent, however, LA combination showed a reduction on serum uric acid levels, which may contribute to a reduction in the metabolic risk in hypertensive patients.
authors.affiliation: Mexican Group for Basic and Clinical Research in Internal Medicine, Motozintla # 30, Col Letran Valle, México D.F. C.P. 03600, México.
authors.forename: Alberto F
authors.initials: AF
authors.lastname: Rubio-Guerra
authors.affiliation: Hospital General de Ticomán SS DF, Mexico City, México.
authors.forename: Ana K
authors.initials: AK
authors.lastname: Garro-Almendaro
authors.affiliation: Hospital General de Ticomán SS DF, Mexico City, México.
authors.forename: Cesar I
authors.initials: CI
authors.lastname: Elizalde-Barrera
authors.affiliation: Mexican Group for Basic and Clinical Research in Internal Medicine, Mexico City, México.
authors.forename: Juan A
authors.initials: JA
authors.lastname: Suarez-Cuenca
authors.affiliation: Mexican Group for Basic and Clinical Research in Internal Medicine, Mexico City, México.|Hospital General de Zona no. 24 IMSS, Mexico City, México.
authors.forename: Montserrat B
authors.initials: MB
authors.lastname: Duran-Salgado
mesh_terms: D017311:Amlodipine / Q000008:administration & dosage*; D000959:Antihypertensive Agents / Q000008:administration & dosage; D015415:Biomarkers / Q000097:blood; D001794:Blood Pressure / Q000187:drug effects*; D004305:Dose-Response Relationship, Drug; D004338:Drug Combinations; D004359:Drug Therapy, Combination; 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; D013997:Time Factors; D016896:Treatment Outcome; D014527:Uric Acid / Q000097:blood*
chemical_list: D000959:Antihypertensive Agents; D015415:Biomarkers; D004338:Drug Combinations; C505809:hydrochlorothiazide, losartan drug combination; D006852:Hydrochlorothiazide; D017311:Amlodipine; D014527:Uric Acid; D019808:Losartan
keywords: amlodipine; combination therapy; hydrochlorothiazide; hypertension; losartan; uric acid