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Clin Exp Nephrol ; 16(2): 269-78, 2012 Apr.
Article in English | MEDLINE | ID: mdl-22127399

ABSTRACT

BACKGROUND: Achieving adequate blood pressure (BP) control often requires more than one antihypertensive agent. The purpose of this study was to determine whether a fixed-dose formulation of losartan (LOS) plus hydrochlorothiazide (HCTZ) (LOS/HCTZ) is effective in achieving a greater BP lowering in patients with uncontrolled hypertension. METHODS: The study was a prospective, multicenter, observational trial exploring the antihypertensive effect of a single tablet of LOS 50 mg/HCTZ 12.5 mg. A total of 228 patients whose BP had previously been treated with more than one antihypertensive agents without having achieved BP goal below 130/80 mmHg enrolled in the study. RESULTS: A significant decrease in systolic and diastolic BP was observed in both clinic and home measurement after switching from the previous treatment to LOS/HCTZ. There was a significant decrease in both B-type natriuretic peptide (BNP) and urinary albumin creatinine (Cr) excretion ratio (ACR), especially in patients with elevated values. In contrast, there was a significant increase in serum Cr concentration in conjunction with a decrease in estimated glomerular filtration rate (eGFR). Overall serum uric acid (UA) concentration increased, whereas in patients with hyperuricemia there was a significant reduction in this value. CONCLUSION: Switching to LOS/HCTZ provides a greater reduction in clinic and home BP in patients with uncontrolled hypertension. This combination therapy may lead to cardio-, reno protection and improve UA metabolism.


Subject(s)
Antihypertensive Agents/therapeutic use , Blood Pressure/drug effects , Hydrochlorothiazide/therapeutic use , Hypertension/drug therapy , Losartan/therapeutic use , Adult , Aged , Blood Pressure Determination , Creatinine/urine , Drug Combinations , Female , Glomerular Filtration Rate , Humans , Hypertension/metabolism , Hypertension/physiopathology , Hyperuricemia , Japan , Male , Middle Aged , Natriuretic Peptide, Brain/blood , Prospective Studies , Treatment Outcome , Uric Acid/blood , Young Adult
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