BACKGROUND AND OBJECTIVES: Although strict blood pressure (BP) control is effective in the prevention of cardiovascular events, it is often insufficient in many hypertensive patients. B-type natriuretic peptide (BNP) has been shown to be associated with cardiovascular events. We investigated the effects of the losartan/hydrochlorothiazide combination on BP and plasma BNP in hypertensive patients uncontrolled by an angiotensin II type 1 receptor antagonist (angiotensin receptor blocker [ARB])-based therapy. METHODS: In a multicentre prospective observational study, we enrolled 185 patients aged 36-79 years (mean age 63.8 years) with essential hypertension but without symptoms of heart failure who received an ARB-based therapy for ≥3 months but failed to achieve a target BP recommended by the Japanese Society of Hypertension (JSH). ARBs were switched to losartan (LOS) 50 mg/hydrochlorothiazide (HCTZ) 12.5 mg. The antihypertensive efficacy, safety, and effects of this combination on blood biochemical parameters and plasma BNP were evaluated for 12 months. RESULTS: Mean ± SD systolic and diastolic BP decreased from 152 ± 13/87 ± 10 mmHg to 128 ± 14/74 ± 10 mmHg, respectively, after 12 months (p < 0.001). Mean ± SD plasma BNP levels decreased significantly from 46.0 ± 83.0 pg/mL to 40.8 ± 68.0 pg/mL (p < 0.05). The percentage of patients who achieved the JSH 2004 target BP was 51% after 12 months; the percentage was 63% in elderly patients aged ≥65 years without complications, and 43% in patients with concomitant diabetes mellitus or chronic kidney disease. No association was found between a decrease in plasma BNP levels and BP, age, body mass index or estimated glomerular filtration rate. There was a significant increase in serum uric acid and a decrease in serum potassium, but both were within the range of normal values. Adverse events were observed in 8.6% of the patients. CONCLUSION: Antihypertensive treatment using two types of drugs (LOS/HCTZ) with different mechanisms yielded potent antihypertensive efficacy with safety and decreased plasma BNP levels.
BACKGROUND AND OBJECTIVES: Although strict blood pressure (BP) control is effective in the prevention of cardiovascular events, it is often insufficient in many hypertensivepatients. B-type natriuretic peptide (BNP) has been shown to be associated with cardiovascular events. We investigated the effects of the losartan/hydrochlorothiazide combination on BP and plasma BNP in hypertensivepatients uncontrolled by an angiotensin II type 1 receptor antagonist (angiotensin receptor blocker [ARB])-based therapy. METHODS: In a multicentre prospective observational study, we enrolled 185 patients aged 36-79 years (mean age 63.8 years) with essential hypertension but without symptoms of heart failure who received an ARB-based therapy for ≥3 months but failed to achieve a target BP recommended by the Japanese Society of Hypertension (JSH). ARBs were switched to losartan (LOS) 50 mg/hydrochlorothiazide (HCTZ) 12.5 mg. The antihypertensive efficacy, safety, and effects of this combination on blood biochemical parameters and plasma BNP were evaluated for 12 months. RESULTS: Mean ± SD systolic and diastolic BP decreased from 152 ± 13/87 ± 10 mmHg to 128 ± 14/74 ± 10 mmHg, respectively, after 12 months (p < 0.001). Mean ± SD plasma BNP levels decreased significantly from 46.0 ± 83.0 pg/mL to 40.8 ± 68.0 pg/mL (p < 0.05). The percentage of patients who achieved the JSH 2004 target BP was 51% after 12 months; the percentage was 63% in elderly patients aged ≥65 years without complications, and 43% in patients with concomitant diabetes mellitus or chronic kidney disease. No association was found between a decrease in plasma BNP levels and BP, age, body mass index or estimated glomerular filtration rate. There was a significant increase in serum uric acid and a decrease in serum potassium, but both were within the range of normal values. Adverse events were observed in 8.6% of the patients. CONCLUSION: Antihypertensive treatment using two types of drugs (LOS/HCTZ) with different mechanisms yielded potent antihypertensive efficacy with safety and decreased plasma BNP levels.
Authors: Y Hirata; A Matsumoto; T Aoyagi; K Yamaoki; I Komuro; T Suzuki; T Ashida; T Sugiyama; Y Hada; I Kuwajima; M Nishinaga; H Akioka; O Nakajima; R Nagai; Y Yazaki Journal: Cardiovasc Res Date: 2001-08-15 Impact factor: 10.787
Authors: Michael H Olsen; Kristian Wachtell; Christian Tuxen; Eigil Fossum; Lia E Bang; Christian Hall; Hans Ibsen; Jens Rokkedal; Richard B Devereux; Per R Hildebrandt Journal: J Hypertens Date: 2005-05 Impact factor: 4.844
Authors: Michael H Olsen; Kristian Wachtell; Christian Tuxen; Eigil Fossum; Lia E Bang; Christian Hall; Hans Ibsen; Jens Rokkedal; Richard B Devereux; Per Hildebrandt Journal: J Hypertens Date: 2004-08 Impact factor: 4.844
Authors: M Kohno; T Horio; K Yokokawa; K Murakawa; K Yasunari; K Akioka; A Tahara; I Toda; K Takeuchi; N Kurihara Journal: Am J Med Date: 1992-01 Impact factor: 4.965
Authors: Mariarosaria Boccellino; Marina Di Domenico; Maria Donniacuo; Giuseppe Bitti; Giulia Gritti; Pasqualina Ambrosio; Lucio Quagliuolo; Barbara Rinaldi Journal: PLoS One Date: 2018-10-24 Impact factor: 3.240