Shiga Yuhei, Miura Shin-Ichiro, Norimatsu Kenji, Hitaka Yuka, Nagata Itsuki, Koyoshi Rie, Morii Joji, Kuwano Takashi, Uehara Yoshinari, Inoue Asao, Shirotani Tetsuro, Fujisawa Kazuaki, Matsunaga Eiyu, Saku Keijiro
Department of Cardiology, Fukuoka University School of Medicine, Japan Inoue Hospital, Fukuoka, Japan Shirotani Hospital, Fukuoka, Japan Fujisawa Clinic, Fukuoka, Japan.
Department of Cardiology, Fukuoka University School of Medicine, Japan Department of Molecular Cardiovascular Therapeutics, Fukuoka University School of Medicine, Japan
J Renin Angiotensin Aldosterone Syst. 2015 Dec;16(4):1078-84. doi: 10.1177/1470320314529358. Epub 2014 Aug 20.
We analyzed the efficacy and safety of combination therapy of high-dose losartan (100 mg/day) and hydrochlorothiazide (HCTZ, 12.5 mg/day) compared with those of the combination of high-dose telmisartan (80 mg/day) and HCTZ (12.5 mg/day).
Forty hypertensive patients who received a combination of high-dose telmisartan and HCTZ were enrolled. We applied a changeover strategy with switching from a combination of high-dose telmisartan and HCTZ to high-dose losartan and HCTZ. We divided the patients into two groups; those who achieved the target blood pressure (controlled group) and those who did not reach the target blood pressure (uncontrolled group) before the changeover and performed further analysis.
The uncontrolled group showed a significant decrease in systolic blood pressure (SBP) (143±12 mmHg to 126±11 mmHg at three months). In addition, serum uric acid significantly decreased in all subjects, and in each of the controlled and uncontrolled groups. There were no significant changes in other biochemical parameters, such as potassium and hemoglobin A1c, at three months after the changeover in all subjects.
Combination therapy with high-dose losartan and HCTZ was superior to the combination of telmisartan and HCTZ with respect to significant decreases in systolic blood pressure and serum uric acid in hypertensive patients.
我们分析了高剂量氯沙坦（100毫克/天）与氢氯噻嗪（HCTZ，12.5毫克/天）联合治疗与高剂量替米沙坦（80毫克/天）与HCTZ（12.5毫克/天）联合治疗的疗效和安全性。
招募了40名接受高剂量替米沙坦和HCTZ联合治疗的高血压患者。我们采用了一种转换策略，从高剂量替米沙坦和HCTZ联合治疗转换为高剂量氯沙坦和HCTZ联合治疗。我们将患者分为两组；转换前达到目标血压的患者（对照组）和未达到目标血压的患者（未控制组），并进行进一步分析。
未控制组的收缩压显著降低（三个月时从143±12毫米汞柱降至126±11毫米汞柱）。此外，所有受试者以及对照组和未控制组的血清尿酸均显著降低。转换三个月后，所有受试者的其他生化参数，如钾和糖化血红蛋白A1c，均无显著变化。
在高血压患者中，高剂量氯沙坦和HCTZ联合治疗在显著降低收缩压和血清尿酸方面优于替米沙坦和HCTZ联合治疗。
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