Rubio-Guerra Alberto F, Garro-Almendaro Ana K, Elizalde-Barrera Cesar I, Suarez-Cuenca Juan A, Duran-Salgado Montserrat B
Mexican Group for Basic and Clinical Research in Internal Medicine, Motozintla # 30, Col Letran Valle, México D.F. C.P. 03600, México.
Hospital General de Ticomán SS DF, Mexico City, México.
Ther Adv Cardiovasc Dis. 2017 Feb;11(2):57-62. doi: 10.1177/1753944716678538. Epub 2016 Dec 8.
Hyperuricemia leads to endothelial dysfunction and insulin resistance, and has been associated with diseases such as hypertension. Antihypertensive drugs modify serum uric acid levels, however, few data are available about their combinations on uricemia. In this study we evaluate the effect of two combinations of losartan, with amlodipine or with hydrochlorothiazide, on serum uric acid levels in hypertensive patients.
A total of 60 hypertensive patients were randomized in two groups; group LA received losartan/amlodipine (100/5 mg) once a day, whereas LH group received losartan hydrochlorothiazide (100/12.5 mg) once a day for 3 months. In both groups serum uric acid levels were measured at the beginning and end of the study. Patients were evaluated monthly for blood pressure (BP) and adverse events. Statistical analysis was performed with a two-way analysis of variance (ANOVA) for repeated measures.
All patients experienced a significant reduction of BP to the same extent (LA 155/94 to 123/79, LH 157/92 to 124/78 mmHg, p > 0.05). In the LA group, serum uric acid decreased from 6.5 ± 1.6 to 4.6 ± 1.3 mg/ml ( p = 0.0001), whereas in the LH group there was a nonsignificant increase from 5.82 ± 1.4 to 5.85 ± 1.5 mg/ml, ( p = 0.936). When both groups were compared, we found a significant reduction ( p < 0.00013) on serum uric acid levels in the LA group.
Both combinations decrease BP values to the same extent, however, LA combination showed a reduction on serum uric acid levels, which may contribute to a reduction in the metabolic risk in hypertensive patients.
高尿酸血症会导致内皮功能障碍和胰岛素抵抗,并与高血压等疾病相关。抗高血压药物会改变血清尿酸水平,然而,关于它们联合使用对尿酸血症影响的数据却很少。在本研究中,我们评估了氯沙坦与氨氯地平或与氢氯噻嗪两种联合用药方案对高血压患者血清尿酸水平的影响。
总共60例高血压患者被随机分为两组;LA组每天服用一次氯沙坦/氨氯地平(100/5毫克),而LH组每天服用一次氯沙坦氢氯噻嗪(100/12.5毫克),持续3个月。在研究开始和结束时测量两组患者的血清尿酸水平。每月对患者进行血压(BP)和不良事件评估。采用重复测量的双向方差分析(ANOVA)进行统计分析。
所有患者的血压均显著降低至相同程度(LA组从155/94降至123/79,LH组从157/92降至124/78毫米汞柱,p>0.05)。在LA组中,血清尿酸从6.5±1.6降至4.6±1.3毫克/毫升(p = 0.0001),而在LH组中,血清尿酸从5.82±1.4毫克/毫升非显著升高至了5.85±1.5毫克/毫升(p = 0.936)。当比较两组时,我们发现LA组的血清尿酸水平显著降低(p < 0.00013)。
两种联合用药方案降低血压值的程度相同,然而,LA联合用药方案可降低血清尿酸水平,这可能有助于降低高血压患者的代谢风险。