2013•Clinical and Experimental HypertensionRequires access
Which is a Better Treatment for Hypertensive Patients with Diabetes: A Combination of Losartan and Hydrochlorothiazide or a Maximum Dose of Losartan?
Haruo Nishimura, Mitsuyo Shintani, Koji Maeda, Kentaro Otoshi, Masahiro Fukuda, Joji Okuda, Shigeo Nishi, Shin-ichiro Ohashi, Sumiko Kato, Yasuto Baba, on behalf of the Biriken Study Group
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Abstract
BACKGROUND: This 12-month study compared the effects of a combination of losartan 50 mg and hydrochlorothiazide 12.5 mg with a maximum dose of losartan (100 mg) in hypertensive patients with diabetes. METHODS: This was a multicenter randomized open-label study. RESULTS: A similar reduction in systolic/diastolic blood pressure from baseline to month 3 was observed in both groups. There was also a similar decrease in UACR in both groups. A significant decrease in uric acid was observed in the maximum-dose group only. eGFR decreased in the combination group after 1 year. CONCLUSIONS: The combination of losartan and a diuretic may be a useful option in such hypertensive patients with diabetes, provided that metabolic parameters are closely monitored. In patients with hyperuricemia and impaired renal function, a maximum dose of losartan may be more beneficial.