Impact of irbesartan, an angiotensin receptor blocker, on uric acid level and oxidative stress in high-risk hypertension patients

Abstract

Hyperuricemia is a known cardiovascular risk factor. The angiotensin II receptor blocker (ARB) losartan is known to decrease serum uric acid (UA) level. A recent in vitro study demonstrated a strong interaction between irbesartan and UA transporters that exceeded that of losartan. The purpose of the present study was to evaluate the hypouricemic effect of irbesartan in a clinical setting. A total of 40 high-risk hypertensive outpatients with coronary artery disease, cerebrovascular disease and/or diabetes complications who were taking ARBs other than irbesartan and losartan were enrolled in this study. After a 4-week control period, the patients' prescribed ARBs were exchanged for an equivalent dose of irbesartan. We assessed blood pressure, heart rate, serum UA level, parameters of lipid and glucose metabolism, cardiac and renal function and inflammatory and oxidative stress markers in blood samples taken immediately before the initiation of irbesartan treatment and again after 12 weeks of treatment. All 40 recruited patients were followed (31 men and 9 women, mean age: 68 years) without any dropouts. During the 12 weeks of irbesartan treatment, no significant changes in blood pressure, heart rate, parameters of lipid or glucose metabolism or other biomarkers of cardiac function, renal function, or inflammation were observed. However, UA level (5.9±1.6 to 5.5±1.6 mg ml(-1), P=0.028) and the oxidative stress marker derivative reactive oxygen metabolites (dROMs) (354±83 to 310±65 U.CARR, P<0.001) were significantly lower at 12 weeks of treatment compared with before treatment. These results suggest that irbesartan has beneficial effects on hyperuricemia and oxidative stress.

Urine metabolic profiles in paediatric asthma

“…Similar findings were reported in animal and human studies, showing decreased serum uric acid levels in asthma patients according to disease severity . The relationship between uric acid, the final product of purine metabolism, inflammation and oxidative stress remains controversial, with studies showing high uric acid concentrations inducing inflammation and oxidative stress, resulting in apoptosis . However, increasing studies showed uric acid as a candidate asthma‐specific biomarker based on its antioxidative roles in decreasing ROS and preventing oxidative damage .…”

The effect of solution environment and the electrostatic factor on the crystallisation of desmotropes of irbesartan

“…14 Recent studies have also shown pharmacological effects of IBS on hyperuricemia, oxidative stress, inammation, lipid metabolism and metabolic syndrome. 15,16 In solution IBS has two interconvertible structures, the 1H-and 2H-tautomers, that differ from one to another by the relative position of a proton in the tetrazole ring (Scheme 1).…”

Increased neutrophil to lymphocyte ratio in persons suffering from hypertension with hyperhomocysteinemia

“…[16][17][18][19] Relevant studies of poor clinical outcome subtypes of hypertension, such as resistant hypertension 21 and non-dipper hypertension, 22 have observed greater NLR values compared with the standard subtype of hypertension; these results appear to support the opinion that the NLR could be used for risk stratification. High-risk hypertensive patients benefited from diminishing oxidative stress in a recent clinical trial, 35 proving the relationship between inflammation and risk from a clinical application point of view. NLR values may be applied to the risk stratification of hypertension if the results of the present study are confirmed in future follow-up studies, and their further application may offer a chance to improve our understanding of pathophysiology and improve treatment for high risk hypertension.…”