Which is a better treatment for hypertensive patients with diabetes: a combination of losartan and hydrochlorothiazide or a maximum dose of losartan?

Autor: Nishimura H; Division of Diabetes and Endocrinology, Osaka Saiseikai Nakatsu Hospital , Osaka , Japan., Shintani M, Maeda K, Otoshi K, Fukuda M, Okuda J, Nishi S, Ohashi S, Kato S, Baba Y
Jazyk: angličtina
Zdroj: Clinical and experimental hypertension (New York, N.Y. : 1993) [Clin Exp Hypertens] 2013; Vol. 35 (8), pp. 582-8. Date of Electronic Publication: 2013 Mar 15.
DOI: 10.3109/10641963.2013.776564
Abstrakt: 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.
Databáze: MEDLINE
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