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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.
Cardiovasc Diabetol. 2013 Nov 04; 12:159.CD

Abstract

BACKGROUND

Angiotensin 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).

METHODS

We 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.

RESULTS

In 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.

CONCLUSIONS

Our 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.

Authors+Show Affiliations

No affiliation info availableDivision of Genomic Epidemiology and Clinical Trials, Clinical Trials Research Center, Nihon University School of Medicine, 30-1 Oyaguchi-Kami Machi, Itabashi-ku, Tokyo 173-8610, Japan. takahashi.yasuo@nihon-u.ac.jp.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Observational Study
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

24180232

Citation

Nishida, Yayoi, et al. "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, vol. 12, 2013, p. 159.
Nishida Y, Takahashi Y, Susa N, et al. 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. Cardiovasc Diabetol. 2013;12:159.
Nishida, Y., Takahashi, Y., Susa, N., Kanou, N., Nakayama, T., & Asai, S. (2013). 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, 12, 159. https://doi.org/10.1186/1475-2840-12-159
Nishida Y, et al. 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. Cardiovasc Diabetol. 2013 Nov 4;12:159. PubMed PMID: 24180232.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - 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. AU - Nishida,Yayoi, AU - Takahashi,Yasuo, AU - Susa,Norio, AU - Kanou,Nobukazu, AU - Nakayama,Tomohiro, AU - Asai,Satoshi, Y1 - 2013/11/04/ PY - 2013/10/02/received PY - 2013/10/29/accepted PY - 2013/11/5/entrez PY - 2013/11/5/pubmed PY - 2014/9/3/medline SP - 159 EP - 159 JF - Cardiovascular diabetology JO - Cardiovasc Diabetol VL - 12 N2 - BACKGROUND: Angiotensin 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). METHODS: We 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. RESULTS: In 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. CONCLUSIONS: Our 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. SN - 1475-2840 UR - https://www.unboundmedicine.com/medline/citation/24180232/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_ L2 - https://cardiab.biomedcentral.com/articles/10.1186/1475-2840-12-159 DB - PRIME DP - Unbound Medicine ER -