Fixed-dose combination of losartan and hydrochlorothiazide significantly improves endothelial function in uncontrolled hypertension by low-dose amlodipine: A randomized study

Abstract

Objective: Flow-mediated dilation (FMD) and nitroglycerin-mediated dilation (NMD) in the brachial artery are well-known indices for evaluating endothelial function (ECF). The blood pressure-lowering effects of the combination of losartan (ARB) and low-dose hydrochlorothiazide (H: ARB-H; ARB, 50 mg and H, 12.5 mg) are useful. The aim of the present study was to examine whether the combination of losartan and low-dose hydrochlorothiazide could improve ECF. Methods: To investigate the effect of ARB-H on ECF in patients with uncontrolled hypertension despite the use of amlodipine (2.5 mg daily), we performed a randomized controlled open-labeled study by using the envelope method and assigned 42 patients to either a control (CTRL) group or an ARB-H combination group, both of which received amlodipine 2.5 mg daily during the treatment period. In addition, both the CTRL (n=21, 69±7 years old) and ARB-H groups (n=21, 69±7 years old) received additional behavioral modification. Before and after 8 weeks of therapy, FMD and NMD were measured in both groups using novel FMD equipment (UNEXEF18G). Results: Although baseline FMD was not different between the two groups, post-therapy FMD increased in the ARB-H group (2.97±1.56 to 3.95±1.86%, p<0.05) but did not change significantly in the CTRL group (2.95±1.43 to 3.11±1.27%, NS). No significant change was seen in NMD when comparing baseline and post-therapy values in either group. No treatment complications were observed. Conclusion: A fixed-dose combination of losartan and hydrochlorothiazide enhances ECF, suggesting that this combination might have both anti-hypertensive and anti-atherosclerotic effects in patients with hypertension. (Anadolu Kardiyol Derg 2014; 14: 685-91)

Comparative Efficacy of Antihypertensive Agents in Flow-Mediated Vasodilation of Patients with Hypertension: Network Meta-Analysis of Randomized Controlled Trial

“…The studies included in our meta-analysis were all RCTs, published until November 2020. The studies were conducted in Italy [ 12 – 19 ], Germany [ 20 ], China [ 21 – 26 ], Turkey [ 27 – 33 ], UK [ 34 ], Brazil [ 35 – 37 ], Greece [ 38 ], Denmark [ 39 ], Korea [ 40 – 45 ], Bulgaria [ 46 ], USA [ 47 ], Chile [ 48 ], and Japan [ 49 – 60 ]. A flow diagram depicting the inclusion process of these studies is shown in Figure 1 .…”

Fixed‐dose vs free‐dose combinations for the management of hypertension—An analysis of 81 958 patients

“…Hypertension affects approximately 24.1% of men and 20.1% of women, corresponding to a total of 1.13 billion adults worldwide. 1 Many different antihypertensive drug combinations have been shown to be effective against this condition [2][3][4][5][6][7] ; however, poor medication persistence and adherence are common problems in hypertensive patients, partly because of complex treatment regimens and high pill burdens. 8,9 This results in sustained periods of uncontrolled hypertension, leading to disease progression and associated economic consequences.…”