Safety and benefits of a tablet combining losartan and hydrochlorothiazide in Japanese diabetic patients with hypertension

Abstract

This study was conducted to determine the effects of a tablet combining losartan/hydrochlorothiazide (L/HCTZ) in comparison with losartan alone in Japanese diabetic patients with hypertension. Thirty consecutive Japanese diabetic patients with hypertension were randomly assigned to group A, receiving losartan alone for the first 3 months, then L/HCTZ for the next 3 months, or group B, receiving L/HCTZ for the first 3 months, then losartan alone for the next 3 months. Clinical and biological parameters were obtained before, and 3 and 6 months after the start of this study. The decreases in systolic and diastolic blood pressure (BP) during treatment with L/HCTZ were significantly greater than in treatment with losartan alone. Both treatments significantly and similarly decreased urinary albumin excretion, the cardio-ankle vascular index (CAVI) and augmentation index (AI). There was no significant difference in metabolic change during both the mono- and combination pharmacotherapies. The tablet combining L/HCTZ significantly reduced systolic and diastolic BP compared with the losartan monotherapy, and offered benefits similar to losartan monotherapy for albuminuria, arterial stiffness assessed by the CAVI and AI, and metabolic effects. Thus, the L/HCTZ tablet could be a useful drug for Japanese diabetic patients with hypertension.

Associations Between Cardio-Ankle Vascular Index and Microvascular Complications in Type 2 Diabetes Mellitus Patients

“…There are many reports about the mechanism of the association between arterial stiffness and albuminuria 21,31) . Among them, endothelial dysfunction may be one of the important mechanisms as it aggravates renal disease, and the progression of renal dysfunction may worsen atherosclerosis; therefore, aggravated renal dysfunction could, in turn, trigger vascular injury and increase arterial stiffness [32][33][34] . Research on diabetic neuropathy has also focused on the pathogenic link between insulin resistance syndrome and endothelial function 35) .…”

Cardio-Ankle Vascular Index (CAVI) as a Novel Indicator of Arterial Stiffness: Theory, Evidence and Perspectives

“…Ishimitsu et al 49) reported that the combination of olmesartan and azelnidipine has advantages over the combination of olmesartan and a thiazide with respect to avoiding increased arterial stiffness in patients with moderate hypertension. A tablet combining losartan and hydrochlorothiazide has been found to decrease CAVI 50) . These clinical data suggest that CAVI might discriminate the causes of hypertension and also the mechanism of blood pressure-lowering agents.…”

Effects of Adding Ezetimibe to Fluvastatin on Kidney Function in Patients with Hypercholesterolemia: a Randomized Control Trial

“…The augmentation index (AI) was measured using an automated tonometric device (HEM-9000AI; Omron Healthcare Co., Ltd., Kyoto, Japan), as described previously 17) . Peripheral pressure waveforms were recorded over 30 seconds from the radial artery at the wrist with the subjects in a sitting position after resting for at least 5 minutes.…”