摘要:

ObjectiveThe 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.DesignRandomized, double-blind, parallel-group study in hypertensive patients.SettingOutpatient clinic.PatientsFollowing a 2- to 3-week single-blind placebo run-in period, 60 patients with sitting diastolic blood pressure ≥ 95 and ≤ 114 mmHg were randomized. Fifty-eight patients completed the study.InterventionsPatients were randomized to receive losartan 50 mg or eprosartan 600 mg once daily for 4 weeks.Main outcome measuresThe 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.ResultsMean urinary uric acid/creatinine changes from baseline were 0.14 (day 1) and 0.11 (week 4) for losartan and 20.04 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 mmol/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 μmol/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.ConclusionsLosartan increased uric acid excretion in hypertensive patients, whilst eprosartan did not. Neither AT-1 receptor antagonist substantially modified serum urate concentrations.

ISSN:0263-6352    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

ObjectiveThe Hypertension Optimal Treatment (HOT) study is a large, prospective trial aimed at defining the level of diastolic blood pressure required during antihypertensive therapy in order to achieve maximal protection against cardiovascular complications. A further aim is to assess the effects on morbidity and mortality of a 75 mg daily dose of aspirin compared with placebo.Subjects and methodsCompliance with double-blind administration of aspirin or placebo added to antihypertensive treatment was evaluated for 1 year in a subset (n= 530) of the study population (n= 18790) by placing the medication in a container closed with an electronic cap that records precisely the time of each opening.ResultsThe 1-year compliance rate (percentage of days with one opening per day) could be assessed in 501 patients. It averaged 78.3 ± 25% in aspirin-treated patients (n= 236, mean ± SD), compared with 78.5 ± 25% in patients having received placebo (n= 265), and was not influenced by age, sex or country (Germany, Italy, Switzerland, UK). The compliance rate was also similar irrespective of whether the patients had reached their target blood pressure, but was significantly better during the first than the second 6-month monitoring period (84.1 ± 22% versus 72.3 ± 32%,n= 501).ConclusionsThe high rate of compliance with aspirin or placebo observed in the HOT study suggests that the patients were highly motivated and may account for the unusually good blood pressure control achieved in this trial during long-term anti-hypertensive treatment.J Hypertens1999, 17:1041–1045 © Lippincott Williams & Wilkins.

ISSN:0263-6352    

出版商:OVID    

年代:1999

数据来源: OVID