Effect of eprosartan and losartan on uric acid metabolism in patients with essential hypertension

被引:61
作者
Puig, JG
Mateos, F
Buño, A
Ortega, R
Rodriguez, F
Dal-Ré, R
机构
[1] La Paz Univ Hosp, Div Internal Med, Madrid, Spain
[2] La Paz Univ Hosp, Div Clin Biochem, Madrid, Spain
[3] SmithKline Beecham Pharmaceut, Dept Med, Madrid, Spain
关键词
blood pressure; eprosartan; losartan; uric acid;
D O I
10.1097/00004872-199917070-00021
中图分类号
R6 [外科学];
学科分类号
1002 ; 100210 ;
摘要
Objective The influence of angiotensin II AT-1 receptor antagonists on uric acid metabolism, and the potential differences among them with regard to this effect, remains to be precisely established. This study was designed to compare the effects of losartan and eprosartan on uric acid metabolism in patients with mild to moderate essential hypertension. Design Randomized, double-blind, parallel-group study in hypertensive patients. Setting Outpatient clinic. Patients Following a 2- to 3-week single-blind placebo run-in period, 60 patients with sitting diastolic blood pressure greater than or equal to 95 and less than or equal to 114 mmHg were randomized. Fifty-eight patients completed the study. Interventions Patients were randomized to receive losartan 50 mg or eprosartan 600 mg once daily for 4 weeks. Main outcome measures The primary endpoint was the change in the ratio of urinary uric acid/creatinine in the period 0-4 h of a 24 h urine collection after 4 weeks of treatment. Secondary endpoints included 24 h urinary uric acid excretion, as well as serum urate and antihypertensive efficacy, Results Mean urinary uric acid/creatinine changes from baseline were 0.14 (day 1) and 0.11 (week 4) for losartan and -0.04 for eprosartan (at both day 1 and week 4; P< 0.01 between groups at both time-points). The mean increase in 24 h urinary uric acid excretion with losartan was 0.7 mmo1/24 h (25% increase from baseline) at both day 1 and week 4. No significant difference was observed in the change of serum urate levels versus baseline between both treatment groups after 4 weeks (-23.4 and - 19.5 mu mol/l for losartan and eprosartan, respectively). Patients with hyperuricaemia in both treatment groups showed similar modifications of uric acid metabolism compared with non-hyperuricaemic subjects. Blood pressure control (sitting diastolic blood pressure < 90 mmHg or <100 mmHg with a decrease of at least 10 mmHg from baseline) was achieved in 22 patients (73%) with eprosartan and in 16 (53%) with losartan, Conclusions Losartan increased uric acid excretion in hypertensive patients, whilst eprosartan did not, Neither AT-1 receptor antagonist substantially modified serum urate concentrations. J Hypertens 1999, 17:1033-1039 (C) Lippincott Williams & Wilkins.
引用
收藏
页码:1033 / 1039
页数:7
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