Dang A, Zhang Y, Liu G, Chen G, Song W, Wang B
Cardiovascular Institute and Fu Wai Hospital, Peking Union Medical College and Chinese Academy of Medical Science, Beijing, Peoples Republic of China.
J Hum Hypertens. 2006 Jan;20(1):45-50. doi: 10.1038/sj.jhh.1001941.
Therapy with losartan compared to irbesartan was performed in a Chinese sample of hypertensive patients with elevated serum uric acid (SUA) levels. After 1 week of screening and a 2 week single-blinded placebo baseline period, patients were treated for 4 weeks with losartan 50 mg or irbesartan 150 mg. After 4 weeks, patients with SiDBP <90 mmHg and SiSBP <140 mmHg continued the same dose regimen for another 4 weeks. If blood pressure was not controlled after 4 weeks of treatment, the dose of either regimen was doubled to losartan 100 mg and irbesartan 300 mg. There were 351 patients randomized (176 to losartan and 175 to irbesartan), and of these, 325 patients completed the study (162 in the losartan group and 163 in the irbesartan group). At baseline, the median SUA level in the losartan group was 422 and 420 micromol/l in the irbesartan group. At 8 weeks of therapy, SUA decreased by 63 mumol/l in the losartan group compared to 12 mumol/l in the irbesartan group (P < 0.0001). Blood pressure declined comparably in both groups from 151/92 mmHg at baseline to 137/83 and 135/83 (losartan and irbesartan, respectively, NS). No severe AEs were found for either treatment group. Therapy with losartan decreased SUA levels significantly more than irbesartan in Chinese patients with hypertension and elevated SUA levels, demonstrating the unique uricosuric effect of this ARB in this ethnic group.
在血清尿酸(SUA)水平升高的中国高血压患者样本中,进行了氯沙坦与厄贝沙坦治疗的对比研究。经过1周的筛查和2周的单盲安慰剂基线期后,患者接受氯沙坦50mg或厄贝沙坦150mg治疗4周。4周后,坐位舒张压(SiDBP)<90mmHg且坐位收缩压(SiSBP)<140mmHg的患者继续使用相同剂量方案再治疗4周。如果治疗4周后血压未得到控制,两种方案的剂量均加倍至氯沙坦100mg和厄贝沙坦300mg。共有351例患者被随机分组(176例接受氯沙坦治疗,175例接受厄贝沙坦治疗),其中325例患者完成了研究(氯沙坦组162例,厄贝沙坦组163例)。基线时,氯沙坦组的SUA中位数水平为422μmol/L,厄贝沙坦组为420μmol/L。治疗8周时,氯沙坦组的SUA下降了63μmol/L,而厄贝沙坦组下降了12μmol/L(P<0.0001)。两组血压从基线时的151/92mmHg均有相当程度下降,分别降至137/83mmHg和135/83mmHg(氯沙坦组和厄贝沙坦组,无显著差异)。两个治疗组均未发现严重不良事件。对于SUA水平升高的中国高血压患者,氯沙坦治疗降低SUA水平的幅度显著大于厄贝沙坦,表明该血管紧张素Ⅱ受体拮抗剂(ARB)在该种族群体中具有独特的促尿酸排泄作用。