Effects of losartan and irbesartan on serum uric acid in hypertensive patients with hyperuricaemia in Chinese population

Abstract

Therapy with losartan compared to irbesartan was performed in a Chinese sample of hypertensive patients with elevated serum uric acid (SUA) levels. After 1 week of screening and a 2 week single-blinded placebo baseline period, patients were treated for 4 weeks with losartan 50 mg or irbesartan 150 mg. After 4 weeks, patients with SiDBPo90 mmHg and SiSBPo140 mmHg continued the same dose regimen for another 4 weeks. If blood pressure was not controlled after 4 weeks of treatment, the dose of either regimen was doubled to losartan 100 mg and irbesartan 300 mg. There were 351 patients randomized (176 to losartan and 175 to irbesartan), and of these, 325 patients completed the study (162 in the losartan group and 163 in the irbesartan group). At baseline, the median SUA level in the losartan group was 422 and 420 lmol/l in the irbesartan group. At 8 weeks of therapy, SUA decreased by 63 lmol/l in the losartan group compared to 12 lmol/l in the irbesartan group (Po0.0001). Blood pressure declined comparably in both groups from 151/92 mmHg at baseline to 137/83 and 135/83 (losartan and irbesartan, respectively, NS). No severe AEs were found for either treatment group. Therapy with losartan decreased SUA levels significantly more than irbesartan in Chinese patients with hypertension and elevated SUA levels, demonstrating the unique uricosuric effect of this ARB in this ethnic group.

High-Normal Serum Uric Acid Is Associated with Impaired Glomerular Filtration Rate in Nonproteinuric Patients with Type 1 Diabetes

“…Thiazide diuretics reportedly increase whereas losartan and ACEi lower uric acid levels (41)(42)(43). In our study, uric acid levels were significantly higher among patients who reported use of thiazide diuretics but use did not confound the relationship between uric acid and cC-GFR.…”

Serum uric acid level in primary hypertension among Chinese nonagenarians/centenarians

“…In this analysis, long-lived subjects with cancer, secondary hypertension, severe heart failure, terminal stage of chronic obstructive pulmonary disease, Alzheimer's disease and Parkinson's disease were excluded. We also excluded subjects who self-reported use of drugs affecting uric acid, such as allopurinol or uricosuric agents, losartan, which have been shown in humans to decrease serum uric acid, 21,22 and diuretic, which could increase serum uric acid concentration. The study population ultimately consisted of 832 long-lived subjects.…”

Effects of Irbesartan on Uric Acid Metabolism in Patients with Treated Essential Hypertension

“…The inhibition of URAT1 by irbesartan exceeded those of losartan in vitro. A large clinical study indicated that the uric acid-lowering effect of irbesartan was less than that of losartan in hypertensive patients with hyperuricemia 22) . These previous studies indicated that the effect of irbesartan on uric acid metabolism in hypertensive patients is still unclear.…”