Assadi Farahnak
Rush University Medical College, Chicago, IL, USA,
J Nephrol. 2014 Feb;27(1):51-6. doi: 10.1007/s40620-013-0009-0. Epub 2013 Dec 13.
Essential hypertension is frequently associated with hyperuricemia in both adult and pediatric patients. Lowering serum uric acid level may provide greater benefit than simply treating hypertension.
Forty-four adolescents, aged 12-19 years, newly diagnosed as essential hypertension (secondary hypertension was excluded) and previously untreated were randomized (open label trial) to receive either enalapril or enalapril plus allopurinol in combination. All participants had baseline serum uric acid level ≥5.5 mg/dl.
Baseline mean blood pressure (BP), age and body mass index were similar between the two groups. After 8 weeks' treatment, BP reduction was greater, percent of treatment group achieving target BP level was greater, and serum uric acid level was lower in the combination treatment group. There were no adverse effects during the course of therapy.
Results suggest that uric acid reduction may be used as adjunctive antihypertensive therapy in hypertensive adolescents with hyperuricemia while closely monitoring for any adverse effect.
在成年和儿科患者中，原发性高血压常与高尿酸血症相关。降低血清尿酸水平可能比单纯治疗高血压带来更大益处。
44名年龄在12至19岁之间、新诊断为原发性高血压（排除继发性高血压）且此前未接受治疗的青少年被随机分组（开放标签试验），分别接受依那普利或依那普利加别嘌醇联合治疗。所有参与者的基线血清尿酸水平均≥5.5mg/dl。
两组之间的基线平均血压（BP）、年龄和体重指数相似。经过8周治疗后，联合治疗组的血压降低幅度更大，达到目标血压水平的治疗组百分比更高，且血清尿酸水平更低。治疗过程中未出现不良反应。
结果表明，在密切监测不良反应的同时，降低尿酸可作为高尿酸血症高血压青少年的辅助抗高血压治疗方法。
