[Losartan - an appropriate antihypertensive drug in patients with gout]

Gout is common, and the prevalence in Sweden is approximately 2%, predominantly men. Of these, 74% also have hypertension. Acute attacks are treated with anti-inflammatory agents. In patients with recurrent disease and high urate levels, urate-lowering treatment is indicated. The first-line treatment is xanthine oxidase inhibitors. Some other drugs lower urate levels, such as Losartan, while beta-blockers and thiazides increase them. Thus, a subsequential question is whether Losartan is sufficient as urate-lowering treatment in patients with gout and hypertension. A PubMed search yielded six relevant articles: two RCTs, two non-randomized studies, and two systematic reviews. The overall results show significant urate-lowering effect, on average 50 µmol/L. Consequently, Losartan is not sufficient as the only urate-lowering treatment for most patients. Switching to Losartan from other blood pressure-lowering drugs reduces urate levels among patients with hypertension and gout.