Document Detail


Effect of losartan versus candesartan on uric acid, renal function, and fibrinogen in patients with hypertension and hyperuricemia associated with diuretics.
MedLine Citation:
PMID:  16448895     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Hyperuricemia may counter benefits of blood pressure (BP) reduction, although this is controversial.
METHODS: We examined the effects of candesartan and losartan on uric acid, creatinine, and fibrinogen. Patients with hypertension and serum uric acid > or = 0.42 mmol/L (7 mg/dL) associated with diuretics were randomized to receive losartan 50 to 100 mg or candesartan 8 to 16 mg for 24 weeks. At randomization and after 24 weeks, systolic and diastolic BP, serum uric acid, creatinine, and fibrinogen were measured.
RESULTS: A total of 59 patients were entered into the study (30 in the losartan and 29 in the candesartan group). Mean systolic and diastolic BP were reduced in the candesartan group, from 156 mm Hg at baseline to 132 mm Hg at 24 weeks, and from 90.9 to 80.8 mm Hg respectively, P < .0001), and in the losartan group from 150.3 to 132 mm Hg and from 89.6 to 77.6 respectively, P < 0001). Overall mean values of fibrinogen levels were again reduced from 4.39 g/L at baseline to 4.01 g/L at 24 weeks (P < .02). Mean values of serum uric acid in the losartan and candesartan groups were similar at baseline (0.44 and 0.46 mmol/L, respectively), but they were lower in the losartan group after 24 weeks (0.39 and 0.48 mmol/L, P = .01). Twelve patients (44%) in the candesartan group had a 10% increase in serum creatinine compared with four patients (14.2%) in the losartan group (P < .02).
CONCLUSIONS: Candesartan and losartan lowered BP, but only losartan reduced uric acid. The lowering of fibrinogen in both groups may explain the reduction in stroke with angiotensin receptor blockers. The effect of persistent hyperuricemia on renal function requires further study.
Authors:
Brian L Rayner; Yvonne A Trinder; Donette Baines; Sedick Isaacs; Lionel H Opie
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  American journal of hypertension     Volume:  19     ISSN:  0895-7061     ISO Abbreviation:  Am. J. Hypertens.     Publication Date:  2006 Feb 
Date Detail:
Created Date:  2006-02-01     Completed Date:  2006-05-25     Revised Date:  2013-05-28    
Medline Journal Info:
Nlm Unique ID:  8803676     Medline TA:  Am J Hypertens     Country:  United States    
Other Details:
Languages:  eng     Pagination:  208-13     Citation Subset:  IM    
Affiliation:
Division of Hypertension, Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa. rayner@curie.uct.ac.za
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MeSH Terms
Descriptor/Qualifier:
Antihypertensive Agents / therapeutic use
Benzimidazoles / therapeutic use*
Blood Pressure / drug effects
Diuretics / adverse effects,  therapeutic use
Female
Fibrinogen / drug effects*,  metabolism
Follow-Up Studies
Glomerular Filtration Rate / drug effects*
Humans
Hypertension / blood,  drug therapy*,  physiopathology
Hyperuricemia / blood*,  chemically induced,  physiopathology
Losartan / therapeutic use*
Male
Tetrazoles / therapeutic use*
Treatment Outcome
Uric Acid / blood*
Chemical
Reg. No./Substance:
0/Antihypertensive Agents; 0/Benzimidazoles; 0/Diuretics; 0/Tetrazoles; 114798-26-4/Losartan; 69-93-2/Uric Acid; 9001-32-5/Fibrinogen; S8Q36MD2XX/candesartan
Comments/Corrections
Comment In:
Am J Hypertens. 2006 Oct;19(10):1093-4   [PMID:  17027836 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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