Comparative effect of angiotensin II type I receptor blockers on serum uric acid in hypertensive patients with type 2 diabetes mellitus: a retrospective observational study

Cardiovascular Diabetology

Original Investigation

Satoshi Asai¹  Nobukazu Kanou¹  Tomohiro Nakayama²  Yayoi Nishida³  Norio Susa³  Yasuo Takahashi³ 

[1] Department of Biomedical Sciences, Division of Pharmacology, Nihon University School of Medicine, 30-1 Oyaguchi-Kami Machi, 173-8610, Itabashi-ku, Tokyo, Japan;Department of Pathology and Microbiology, Division of Laboratory Medicine, Nihon University School of Medicine, 30-1 Oyaguchi-Kami Machi, 173-8610, Itabashi-ku, Tokyo, Japan;Division of Genomic Epidemiology and Clinical Trials, Clinical Trials Research Center, Nihon University School of Medicine, 30-1 Oyaguchi-Kami Machi, 173-8610, Itabashi-ku, Tokyo, Japan;

关键词: ARB monotherapy;    Losartan;    Valsartan;    Telmisartan;    Candesartan;    Olmesartan;    Serum uric acid;    Hypertension;    Type 2 diabetes mellitus;   

DOI  :  10.1186/1475-2840-12-159

 received in 2013-10-02, accepted in 2013-10-29,  发布年份 2013

来源: Springer

【 摘 要 】

BackgroundAngiotensin II type 1 receptor blockers (ARB) are a frequently used class of antihypertensive drug. The ARB losartan is known to decrease the serum uric acid (SUA) level. However, there are very few clinical data comparing the effects of other ARBs on SUA level under the conditions of clinical practice. This study evaluated and compared the long-term effects of monotherapy with five ARBs on SUA level in Japanese hypertensive patients with type 2 diabetes mellitus (DM).MethodsWe identified hypertensive patients with type 2 DM who had been treated with monotherapy with losartan (n = 214), valsartan (n = 266), telmisartan (n = 185), candesartan (n = 458), or olmesartan (n = 192), in whom laboratory data of SUA between November 1, 2004 and July 31, 2011 were available, from the Nihon University School of Medicine’s Clinical Data Warehouse (NUSM’s CDW). We used a propensity-score weighting method and a multivariate regression model to adjust for differences in the background among ARB users, and compared the SUA level. The mean exposure of losartan was 264.7 days, valsartan 245.3 days, telmisartan 235.9 days, candesartan 248.9 days, and olmesartan 234.5 days.ResultsIn losartan users, mean SUA level was significantly decreased from baseline, while it was conversely increased in users of other ARBs; valsartan, telmisartan, candesartan, and olmesartan. The mean reduction of SUA level from baseline was significantly greater in losartan users compared with that in other ARB users. Comparison of ARBs other than losartan showed no significant difference in mean change in SUA level from baseline.ConclusionsOur study showed that losartan had the most beneficial effect on SUA level among five ARBs, and that there was no significant difference in the unfavorable effects on SUA level among four ARBs other than losartan, at least during one year. These findings provide evidence of an effect of ARBs on SUA level, and support the benefit of the use of losartan in hypertensive patients with type 2 DM.

【 授权许可】

Unknown   
© Nishida et al.; licensee BioMed Central Ltd. 2013. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.