Antihypertensive effect of a fixed-dose combination of losartan /hydrochlorothiazide in patients with uncontrolled hypertension: a multicenter study

Hosoya, Tatsuo; Kuriyama, Satoru; Ohno, Iwao; Kawamura, Tetsuya; Ogura, Makoto; Ikeda, Masato; Ishikawa, Masahiro; Hayashi, Fumihiro; Kanai, Tatsuya; Tomonari, Haruo; Soejima, Mitsuhiro; Akaba, Kiyoaki; Tokudome, Goro

doi:10.1007/s10157-011-0564-4

Cited by 10 publications

(13 citation statements)

References 32 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The JOINT study was a multicenter observational selfcontrolled study to evaluate the antihypertensive effect of a fixed-dose combination formulation of LOS/HCTZ (Clinical trial Number by UMIN 000001950) (8). The study was conducted at 28 medical institutions in the vicinity of Tokyo, including four affiliated hospitals of the Jikei University School of Medicine.…”

Section: Methodsmentioning

confidence: 99%

“…Among 228 participants in the JOINT study (8), a total of 164 patients, whose blood and urinary UA specimens were available, were finally analyzed. Table 1 shows the patient basal characteristics at entry into the study.…”

Section: Patient Selectionmentioning

confidence: 99%

“…The authors would like to thank all of the investigators listed elsewhere (8) for their participation in the JOINT study. The JOINT study was supported by a grant from the Kidney Foundation, Japan.…”

Section: Acknowledgementmentioning

confidence: 99%

“…As part of the Jikei Optimal Antihypertensive Treatment (JOINT) study, we have previously reported that LOS/HCTZ exerted an excellent antihypertensive effect after patients switched from their prior antihypertensive drugs (8). The present trial is an extensional analysis of the results obtained in the JOINT study, focusing on the effect of LOS/HCTZ on the UA metabolism.…”

Section: Introductionmentioning

confidence: 97%

“…This effect could be mediated by the inhibition of the urate transporter 1 (URAT-1) in the renal tubules, thus leading to enhanced UA excretion (5-7). Owing to this specific benefit on UA metabolism, LOS has been known to ameliorate diuretic-induced hyperuricemia (8,9). The elevation in the sUA induced by diuretics may also be decreased when used in combination with ARBs (5,8).…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Effects of Combined Antihypertensive Therapy with Losartan/Hydrochlorothiazide on Uric Acid Metabolism

et al. 2012

Self Cite

View full text Add to dashboard Cite

Objective The Jikei Optimal Antihypertensive Treatment (JOINT) study originally evaluated the effect of a fixed-dose formulation of losartan (LOS) (50 mg) plus 12.5 hydrochrolthiazide (HCTZ) for achieving better blood pressure (BP) control in patients with uncontrolled hypertension. This study is a sub-analysis of the JOINT study, focusing on the effect of LOS/HCTZ on the uric acid (UA) metabolism. Methods Among 228 participants in the JOINT study, a total of 164 patients whose blood and urinary UA specimens were available were included in the present analyses. Results Six months after switching from the prior antihypertensive agent(s) to a single tablet formulation of LOS/HCTZ, the overall serum UA concentration (sUA) increased from 6.0 ± 1.6 mg/dL to 6.2 ± 1.6 mg/dL (p=0.029). The urinary UA/creatinine (Cr) ratio increased from 0.45 +/-0.21 to 0.50 +/-0.25 (p=0.014), and the fractional excretion of UA (FEUA) also increased, from 7.1 +/-3.6 to 7.0 +/-4.3, p=0.04). Multivariate regression analyses of the basal parameters showed the change in sUA (ΔUA) to correlate with the basal sUA (β=-0.483, p<0.001), estimated glomerular filtration rate (eGFR) (β=-0.202, p=0.007) and systolic BP (β= 0.147, p=0.038). In addition, the ΔUA also correlated with the changes in the estimated glomerular filtration rate (ΔeGFR) (β=-0.332, p<0.001). When the patients were classified into two groups depending on their basal sUA, those with a basal sUA ! 7 mg/dL exhibited a decrease in their sUA, whereas the rest of those with a sUA <7 mg/dL experienced an increase. Furthermore, patients who had previously been treated with LOS alone had a greater increase in the sUA than those treated with an angiotensin II blocker (ARB) other than LOS alone. Conclusion Antihypertensive therapy with a single tablet formulation of LOS/HCTZ is considered to be a useful option for controlling both BP and sUA, especially in uncontrolled hypertensive patients with hyperuricemia.

show abstract

Section: Methodsmentioning

confidence: 99%

Section: Patient Selectionmentioning

confidence: 99%

Section: Acknowledgementmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 97%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Effects of Combined Antihypertensive Therapy with Losartan/Hydrochlorothiazide on Uric Acid Metabolism

et al. 2012

Self Cite

View full text Add to dashboard Cite

show abstract

Association of co-exposure to heavy metals with renal function in a hypertensive population

Zhang

Jiang

et al. 2018

Environment International

View full text Add to dashboard Cite

Significance of estimated salt excretion as a possible predictor of the efficacy of concomitant angiotensin receptor blocker (ARB) and low-dose thiazide in patients with ARB resistance

et al. 2013

View full text Add to dashboard Cite

The purpose of this study was to assess the factors affecting the efficacy of combination therapy with losartan and thiazide, with a focus on the significance of salt excretion, via a multicenter observational study. Adult patients with essential hypertension showing therapy resistance to angiotensin receptor blocker (ARB) as a monotherapy or in combination with Ca channel blockers (CCB) were enrolled, and their previously administered ARBs were replaced with the combination tablet containing losartan (50 mg per day) and hydrochlorothiazide (12.5 mg per day). Blood pressure and biochemical parameters were monitored for a year. The baseline blood pressure (153.4±14.8/86.4±11.3 mm Hg) was significantly lowered at the 3rd month (137.3±17.4/78.2±11.1 mm Hg, n=93) and was maintained at this lower level until the 12th month (135.3±14.0/76.4±11.1 mm Hg, n=74). The baseline value of estimated salt excretion (eSE), calculated using Tanaka's formula, differed significantly between the high and low treatment response groups, which were defined by the average change in mean blood pressure (MBP-C, -11.3 mm Hg; eSE=10.8±2.9 g per day in high responders vs. 9.2±2.3 g per day in low responders, P=0.004). Univariate and multivariate analyses showed a significant correlation between eSE and MBP-C (R=-0.288, P=0.007) and indicated the clinical effectiveness of eSE as a possible predictor for MBP-C (P=0.021). In addition, the urine Na-to-Cr ratio (NCR) demonstrated significant correlations with eSE (R=0.848, P<0.001) and MBP-C (R=-0.344, P<0.001). These results suggest that eSE or NCR could, to a certain extent, predict the efficacy of combination therapy with losartan and low-dose thiazide in patients demonstrating ARB resistance. Combination therapy with losartan and thiazide might thus be suitable for patients with a large amount of salt excretion.

show abstract

Antihypertensive effect of a fixed-dose combination of losartan /hydrochlorothiazide in patients with uncontrolled hypertension: a multicenter study

Cited by 10 publications

References 32 publications

Effects of Combined Antihypertensive Therapy with Losartan/Hydrochlorothiazide on Uric Acid Metabolism

Effects of Combined Antihypertensive Therapy with Losartan/Hydrochlorothiazide on Uric Acid Metabolism

Association of co-exposure to heavy metals with renal function in a hypertensive population

Significance of estimated salt excretion as a possible predictor of the efficacy of concomitant angiotensin receptor blocker (ARB) and low-dose thiazide in patients with ARB resistance

Contact Info

Product

Resources

About