Low adherence to an antihypertensive-drug regimen was associated with poor BP control.

Salt restriction is widely recommended for the prevention and management of hypertension. It is very important to reduce salt intake during childhood. This survey was conducted to investigate salt intake in Japanese children. The study subjects, totalling 1424, comprised 3-year-old children who received health checkups conducted by a public health center. Using first-morning urine samples, urinary concentrations of sodium, potassium and creatinine were measured. Additionally, the participants' parents filled out a questionnaire regarding their children's dietary habits. Urinary sodium and potassium concentrations were 140 ± 67 and 67 ± 41 mmol l À1 , respectively. The estimated urinary sodium excretion values had a wide distribution, with a mean value of 75±47 mmol per day (4.4 g per day of salt). Sodium excretion exceeded 100 and 200 mmol per day in 336 (24%) and 32 (2.2%) subjects, respectively. Urinary sodium excretion was significantly higher in children who had older siblings than in firstborn children (78 ± 49 vs. 72 ± 45 mmol per day, Po0.05). The urinary sodium/potassium ratio was also higher in the former group (3.0±2.7 vs. 2.7±2.2, Po0.01). Sodium excretion tended to be higher in children who ate daily snacks than in those who did not (76±48 vs. 71±44 mmol per day, P¼0.07). In contrast, potassium excretion was significantly higher and the sodium/potassium ratio was lower in children who ate fruits daily than those who did not (39 ± 29 vs. 33 ± 23 mmol per day and 2.6 ± 2.0 vs. 3.2 ± 2.7, Po0.01, respectively). These results suggest that excess salt intake occurs in a significant number of 3-year-old Japanese children. The presence of older siblings and dietary habits of eating snacks or fruits influence their sodium and potassium intake.

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.