Fan Yu, Wei Feifei, Lang Yakun, Wang Shijun
aCancer Institute bInstitute of Molecular Biology & Translational Medicine, Affiliated People's Hospital, Jiangsu University, Zhenjiang, Jiangsu, PR China.
J Hypertens. 2015 Apr;33(4):681-8; discussion 689. doi: 10.1097/HJH.0000000000000478.
Many studies have compared losartan with other antihypertensive agents in the management of hypertensive patients with hyperuricaemia in China. However, systematic assessment of efficacy and safety between losartan and other antihypertensive agents is still lacking. This meta-analysis sought to evaluate the available randomized controlled trials (RCTs) regarding losartan treatment for hypertensive patients with hyperuricaemia in China.
Cochrane Library, PubMed, EMBASE, Chinese National Knowledge Infrastructure, and Wanfang database were searched until December 2013. Only RCTs comparing losartan with other antihypertensive agents for the management of hypertensive patients with hyperuricaemia in Chinese patients were included.
Thirty-one RCTs with 2754 patients were identified. Losartan reduced serum uric acid levels (weighted mean differences - 1.57 mg/dl, 95% confidence interval -1.83 to -1.30) compared with other antihypertensive agents. No significant differences in the reduction in SBP or DBP were observed. The incidence of adverse events was comparable between losartan and other agents, so no differences were found in dizziness and headache. Losartan generated a lower incidence than angiotensin-converting enzyme inhibitors of reported dry cough (risk ratio 0.19, 95% confidence interval 0.10-0.36).
There are no significant differences between losartan and other antihypertensive agents in the reduction of blood pressure. However, losartan is superior to other agents in the reduction of serum uric acid levels; it might be a better choice in hypertensive patients with hyperuricaemia.
在中国，许多研究已将氯沙坦与其他抗高血压药物用于高尿酸血症高血压患者的治疗中进行了比较。然而，氯沙坦与其他抗高血压药物之间疗效和安全性的系统评估仍很缺乏。本荟萃分析旨在评估中国关于氯沙坦治疗高尿酸血症高血压患者的现有随机对照试验（RCT）。
检索Cochrane图书馆、PubMed、EMBASE、中国知网和万方数据库直至2013年12月。仅纳入在中国患者中比较氯沙坦与其他抗高血压药物用于治疗高尿酸血症高血压患者的RCT。
共纳入31项RCT，涉及2754例患者。与其他抗高血压药物相比，氯沙坦可降低血清尿酸水平（加权平均差-1.57mg/dl，95%置信区间-1.83至-1.30）。收缩压或舒张压降低方面未观察到显著差异。氯沙坦与其他药物不良事件发生率相当，头晕和头痛方面未发现差异。氯沙坦导致的干咳发生率低于血管紧张素转换酶抑制剂（风险比0.19，95%置信区间0.10 - 0.36）。
氯沙坦与其他抗高血压药物在降低血压方面无显著差异。然而，氯沙坦在降低血清尿酸水平方面优于其他药物；对于高尿酸血症高血压患者，它可能是更好的选择。
