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.

Zhengganxifeng Decoction Affects Gut Microbiota and Reduces Blood Pressure <i>via</i> Renin–Angiotensin System

“…Famous anti-hypertensives, such as benazepril, captopril, enalapril and losartan, all reduce blood pressure through RAS system. [41][42][43][44] In the present study, the influence of ZGXFD on gut microbial composition was similar to that of benazepril, thus making us consider that ZGXFD might affect blood pressure by RAS system as well. Our results provide evidence for the hypothesis.…”

Personalizing the Diuretic Treatment of Hypertension: the Need for More Clinical and Research Attention

“…In patients in whom gout develops or is exacerbated, reducing dosage or switching to a drug class other than a diuretic, or possibly to spironolactone, should be considered. The ARB losartan lowers uric acid levels slightly in diuretic-treated patients, and may reduce the incidence of diuretic-induced gout [57,58]. Most important, even if gout has occurred, if a thiazide or loop diuretic is truly needed, it should be prescribed, along with an agent such as allopurinol or febuxostat to reduce the serum uric acid level.…”

Гіперурикемія Й Артеріальна Гіпертензія — Чи Існує Зв’язок?

“…Протилежним чином діє блокатор АТ 1 -рецепторів ангіотензину ІІ лозартан, який збільшує екскрецію сечової кислоти нирками, тим самим зменшує її вміст в сироватці крові в середньому на 20-25 %, що продемонстровано в чисельних дослідженнях у хворих на АГ [39]. Так, у дослідженні японських науковців продемонстровано, що перехід пацієнтів з комбінації блокаторів рецепторів ангіотензину ІІ з тіазидним або тіазидоподібним діуретиком на комбінацію лозартану з гідрохлоротіазидом супроводжується достовірним зменшенням сироваткової концентрації сечової кислоти у хворих на ГХ [40]. Важливим є той факт, що зниження рівня сечової кислоти під впливом лозартану супроводжується поліпшенням прогнозу, що було продемонстровано в пацієнтів з діабетичною нефропатією [41].…”