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Angiotensin receptor blocker (ARB)-diuretic versus ARB-calcium channel blocker combination therapy for hypertension

Jin Oshikawa1, Yoshiyuki Toya, Satoshi Morita

  • 1Department of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine , Yokohama , Japan .

Clinical and Experimental Hypertension (New York, N.Y. : 1993)
|July 16, 2013
PubMed

Insights

Losartan-hydrochlorothiazide and losartan-amlodipine combination therapies showed similar blood pressure control over 12 months. Losartan-hydrochlorothiazide increased serum uric acid in patients with low baseline levels.

Area of Science:

  • Cardiology
  • Pharmacology
  • Nephrology

Background:

  • Angiotensin II receptor blockers (ARBs) are frequently combined with diuretics or calcium channel blockers (CCBs) for hypertension management.
  • Optimal ARB-based combination therapy regarding efficacy and safety remains undetermined.

Purpose of the Study:

  • To compare the efficacy and safety of fixed-dose losartan-hydrochlorothiazide (LST-HCTZ) versus losartan-amlodipine (LST-AML) in Japanese patients with uncontrolled hypertension on ARB monotherapy.

Main Methods:

  • A prospective, randomized, open-label study involving 99 patients on LST-HCTZ and 77 patients on LST-AML.
  • Patients had hypertension uncontrolled by ARB monotherapy.
  • Outcomes assessed over a 12-month study period.

Main Results:

  • Both LST-HCTZ and LST-AML demonstrated similar blood pressure reduction over 12 months.
  • LST-HCTZ significantly increased serum uric acid (SUA) in patients with low baseline SUA (<5.6 mg/dL).
  • No significant increase in SUA was observed in patients with high baseline SUA.

Conclusions:

  • Fixed-dose LST-HCTZ and LST-AML are similarly effective in controlling hypertension over 12 months.
  • LST-HCTZ may increase SUA in specific patient subgroups, warranting consideration in treatment selection.

Keywords:
Angiotensin receptor antagonistscombinationcomparative studydrug therapyhypertensionsodium chloride symporter inhibitors

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