A Systematic Review of Losartan versus Valsartan for Essential Hypertension Associated with Hyperuricemia_Chinese Journal of Evidence-Based Medicine

Authors：

LIU Yifan ^1,2 , MA Bin ¹ , YANG Kehu ¹ , JIA Jintang ² ,  CHEN Hui ³

1. Evidence-based Medicine Center , Basic Medical Sciences School of Lanzhou University, Lanzhou 730000,China;2. The Second People’s Hospital of Lanzhou,Lanzhou 730000,China;3. The Second Hospital of Lanzhou Universtiy,Lanzhou730000,China;

Corresponding author：

CHEN Hui, Email: chenhui02@sohu.com

Keywords：

Losartan; Valsartan; Essential hypertension; Typeruricemia; Efficacy; Safety; Systematic review

DOI：

10.7507/1672-2531.20090081

Video：

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Objective 　To assess the efficacy and safety Losartan for essential hypertension associated with
hyperuricemia.
Methods 　Included randomized controlled trials of Losartan versus Valsartan. Electronic search
conducted in CENTRAL, the Cochrane Library (until 2008, Issue 4), PubMed, EMBASE, Chinese Biomedicine database,
Chinese Scientific Journals Full-text Database, and China Journal Full-text Database (until 2008, Issue 10). Two reviewers extracted data independently. RevMan 5.0 software developed by the Cochrane Collaboration was used for Metaanalysis.
Results 　Only 7 trials with 1 136 eligible patients were included in the systematic review. Meta-analysis showed
no significant difference in reductions of systolic blood pressure, diastolic blood pressure, and adverse events between
Losartan and Valsartan groups. However, a significant difference of serum uric acid reduction was observed between
Losartan and Valsartan group. Losartan play a significant role of decreased serum uric acid levels.
Conclusions　 Based on this systematic review, Losartan is effective and well tolerated in reducing BP and serum uric acid levels. Further large randomized, double blind, placebo controlled trials are needed in long-term safety and efficacy and different subgroups of Losartan.

Citation： LIU Yifan,MA Bin,YANG Kehu,JIA Jintang,CHEN Hui. A Systematic Review of Losartan versus Valsartan for Essential Hypertension Associated with Hyperuricemia. Chinese Journal of Evidence-Based Medicine, 2009, 09(4): 430-436. doi: 10.7507/1672-2531.20090081 Copy

1.	Joss F, Farinro E, Panico S, et al. Serum uric acid and hypertension. the Olivetti Heart Study. Journal of Human Hypertension, 1994, 8(9):677-681.
2.	党爱民, 刘国仗, 张宇辉, 等. 血管紧张素Ⅱ受体拮抗剂干预高血压患者尿酸代谢的对比研究. 中华心血管病杂志, 2006, 34(10):.
3.	张韶文, 黄玲, 王小英. 氯沙坦治疗高血压伴高尿酸血症的临床观察. 浙江预防学, 2006, 18(4):77-77.
4.	叶任高. 内科学. 第5版. 北京: 人民卫生出版社, 2001. 878-880.
5.	阴赤贞茜, 杜心清, 许朝祥. 老年收缩期高血压患者血清尿酸水平及氯沙坦钾的治疗作用. 现代康复. 2001, 5(5): 86-87.
6.	李艳萍. 氯沙坦、缬沙坦联合氨氯地平治疗原发性高血压并高尿酸血症的对比研究. 南华大学学报医学版, 2007, 35(3): 404-406.
7.	Baguet JP, Robitail S, Boyer L, et al. A meta-analytical approach to the efficacy of antihypertensive drugs in reducing blood pressure. American Journal of Cardiovascular Drugs, 2005, 5(2): 131-140.
8.	Bomalaski JS, Clark MA. Serum uric acid-lowering therapies: where are we heading in management of hyperuricemia and the potential role of uricase. Curr Rheumatol Rep, 2004, 6(3): 240-247.
9.	吕湛, 王周碧, 陈运贞. 科素亚对高血压病患者血浆尿酸水平的影响及意义. 2002, 31(2): 130-132.
10.	Diez J. Review of the molecular pharmacology of Losartan and its possible relevance to stroke prevention in patients with hypertension. Clin Ther, 2006, 28(6): 832-848.
11.	Puig JG, Torres R, Ruilope LM, et al. AT1 blockers and uric acid metabolism: are there relevant differences? J Hypertens Suppl, 2002, 20(5): S29-31.
12.	Rayner BL, Trinder YA, Baines D, et al. Effect of losartan versus candesartan on uric acid, renal function, and fibrinogen in patients with hypertension and hyperuricemia associated with diuretics. Am J Hypertens, 2006, 19(2): 208-213.
13.	曾群英, 麦炜颐, 高修仁, 等. 两种不同血管紧张素ⅡⅠ型受体拮抗剂治疗轻中度原发性高血压的临床研究. 中国医药导刊, 2000, 2(5): 182-152.
14.	张宁萍. 氯沙坦和缬沙坦对老年高血压患者疗效的比较. 新乡医学院学报, 2005, 22(2): 145-146.
15.	曾群英, 麦炜颐, 何清, 等. 两种AT1拮抗剂治疗轻中度原发性高血压的临床研究. 中国临床药理学杂志, 2001, 17(3): 182-185.
16.	易远明. 氯沙坦与缬沙坦对老年高血压患者血尿酸及尿α1-微球蛋白的影响. 实用临床医学, 2006, 7(2): 8-10.
17.	杨新滨. 氯沙坦与缬沙坦对老年高血压患者血尿酸及尿A12 微球蛋白的影响. 药物与临床, 2008, 5(17): 80-81.
18.	Elliott WJ, Calhoun DA, DeLucca PT, et al. Losartan versus valsartan in the treatment of patients with mild to moderate essential hypertension: data from a multicenter, randomized, double-blind, 12-week trial. Clin Ther, 2001, 23(8): 1166-1179.
19.	Monterroso VH, Chavez VR, Carbajal ET, et al. Use of ambulatory blood pressure monitoring to compare antihypertensive efficacy and safety of two angiotensin II receptor antagonists, losartan and valsartan, Losartan Trial Investigators. Adv Ther, 2000, 17(2): 117-131.
20.	Fauvel JP, Velon S, Berra N, et al. Effects of losartan on renal function in patients with essential hypertension. J Cardiovasc Pharmacol, 1996, 28(2): 259-263.
21.	Lacourciere YA, Belanger A, Godin C, et al. Long-term comparison of losartan and enalapril on kidney function in hypertensive type 2 diabetics with early nephropathy. Kidney Int, 2000, 58(2): 762-769.
22.	Leu JG, Huang CM, Kao SJ, et al. Efficacy and safety of losartan in patients with proteinuria. Nephron, 2002, 91(3): 496-498.
23.	Mora-Macia J, Cases A, Calero F, et al. Effect of angiotensin II receptor blockade on renal disease progression in patients with non-diabetic chronic renal failure. Nephrol Dial Transplant, 2001,16(Suppl 1): 82-84.
24.	Gansevoort RT, Zeeuw D, Shahinfar S, et al. Effects of the angiotensin II antagonist losartan in hypertensive patients with renal disease. J Hypertens Suppl, 1994, 12(2): S37-42.
25.	Rayner BL, Trinder YA, Baines D, et al. Effect of losartan versus candesartan on uric acid, renal function, and fibrinogen in patients with hypertension and hyperuricemia associated with diuretics. Am J Hypertens, 2006, 19(2): 208-213.
26.	宗可诚, 魏慧敏, 高春红, 等. 缬沙坦的降压效果及对血尿酸、尿蛋白的影响. 滨州医学院学报, 2006, 29(2): 96-98.27 庄梅, 方颖. 原发性高血压与高尿酸血症的关系. 贵阳医学院学报, 2002, 27(3): 223-228.
27.	Alderman MH, Kivlighn S, Beauchard L, et al. Increasedserum uric acid associated with increased cardiovascular disease in treated hypertensive patients. J Hypertens. 1998, 16( suppl 2) : S5.
28.	-885.

1. Joss F, Farinro E, Panico S, et al. Serum uric acid and hypertension. the Olivetti Heart Study. Journal of Human Hypertension, 1994, 8(9):677-681.
2. 党爱民, 刘国仗, 张宇辉, 等. 血管紧张素Ⅱ受体拮抗剂干预高血压患者尿酸代谢的对比研究. 中华心血管病杂志, 2006, 34(10):.
3. 张韶文, 黄玲, 王小英. 氯沙坦治疗高血压伴高尿酸血症的临床观察. 浙江预防学, 2006, 18(4):77-77.
4. 叶任高. 内科学. 第5版. 北京: 人民卫生出版社, 2001. 878-880.
5. 阴赤贞茜, 杜心清, 许朝祥. 老年收缩期高血压患者血清尿酸水平及氯沙坦钾的治疗作用. 现代康复. 2001, 5(5): 86-87.
6. 李艳萍. 氯沙坦、缬沙坦联合氨氯地平治疗原发性高血压并高尿酸血症的对比研究. 南华大学学报医学版, 2007, 35(3): 404-406.
7. Baguet JP, Robitail S, Boyer L, et al. A meta-analytical approach to the efficacy of antihypertensive drugs in reducing blood pressure. American Journal of Cardiovascular Drugs, 2005, 5(2): 131-140.
8. Bomalaski JS, Clark MA. Serum uric acid-lowering therapies: where are we heading in management of hyperuricemia and the potential role of uricase. Curr Rheumatol Rep, 2004, 6(3): 240-247.
9. 吕湛, 王周碧, 陈运贞. 科素亚对高血压病患者血浆尿酸水平的影响及意义. 2002, 31(2): 130-132.
10. Diez J. Review of the molecular pharmacology of Losartan and its possible relevance to stroke prevention in patients with hypertension. Clin Ther, 2006, 28(6): 832-848.
11. Puig JG, Torres R, Ruilope LM, et al. AT1 blockers and uric acid metabolism: are there relevant differences? J Hypertens Suppl, 2002, 20(5): S29-31.
12. Rayner BL, Trinder YA, Baines D, et al. Effect of losartan versus candesartan on uric acid, renal function, and fibrinogen in patients with hypertension and hyperuricemia associated with diuretics. Am J Hypertens, 2006, 19(2): 208-213.
13. 曾群英, 麦炜颐, 高修仁, 等. 两种不同血管紧张素ⅡⅠ型受体拮抗剂治疗轻中度原发性高血压的临床研究. 中国医药导刊, 2000, 2(5): 182-152.
14. 张宁萍. 氯沙坦和缬沙坦对老年高血压患者疗效的比较. 新乡医学院学报, 2005, 22(2): 145-146.
15. 曾群英, 麦炜颐, 何清, 等. 两种AT1拮抗剂治疗轻中度原发性高血压的临床研究. 中国临床药理学杂志, 2001, 17(3): 182-185.
16. 易远明. 氯沙坦与缬沙坦对老年高血压患者血尿酸及尿α1-微球蛋白的影响. 实用临床医学, 2006, 7(2): 8-10.
17. 杨新滨. 氯沙坦与缬沙坦对老年高血压患者血尿酸及尿A12 微球蛋白的影响. 药物与临床, 2008, 5(17): 80-81.
18. Elliott WJ, Calhoun DA, DeLucca PT, et al. Losartan versus valsartan in the treatment of patients with mild to moderate essential hypertension: data from a multicenter, randomized, double-blind, 12-week trial. Clin Ther, 2001, 23(8): 1166-1179.
19. Monterroso VH, Chavez VR, Carbajal ET, et al. Use of ambulatory blood pressure monitoring to compare antihypertensive efficacy and safety of two angiotensin II receptor antagonists, losartan and valsartan, Losartan Trial Investigators. Adv Ther, 2000, 17(2): 117-131.
20. Fauvel JP, Velon S, Berra N, et al. Effects of losartan on renal function in patients with essential hypertension. J Cardiovasc Pharmacol, 1996, 28(2): 259-263.
21. Lacourciere YA, Belanger A, Godin C, et al. Long-term comparison of losartan and enalapril on kidney function in hypertensive type 2 diabetics with early nephropathy. Kidney Int, 2000, 58(2): 762-769.
22. Leu JG, Huang CM, Kao SJ, et al. Efficacy and safety of losartan in patients with proteinuria. Nephron, 2002, 91(3): 496-498.
23. Mora-Macia J, Cases A, Calero F, et al. Effect of angiotensin II receptor blockade on renal disease progression in patients with non-diabetic chronic renal failure. Nephrol Dial Transplant, 2001,16(Suppl 1): 82-84.
24. Gansevoort RT, Zeeuw D, Shahinfar S, et al. Effects of the angiotensin II antagonist losartan in hypertensive patients with renal disease. J Hypertens Suppl, 1994, 12(2): S37-42.
25. Rayner BL, Trinder YA, Baines D, et al. Effect of losartan versus candesartan on uric acid, renal function, and fibrinogen in patients with hypertension and hyperuricemia associated with diuretics. Am J Hypertens, 2006, 19(2): 208-213.
26. 宗可诚, 魏慧敏, 高春红, 等. 缬沙坦的降压效果及对血尿酸、尿蛋白的影响. 滨州医学院学报, 2006, 29(2): 96-98.27 庄梅, 方颖. 原发性高血压与高尿酸血症的关系. 贵阳医学院学报, 2002, 27(3): 223-228.
27. Alderman MH, Kivlighn S, Beauchard L, et al. Increasedserum uric acid associated with increased cardiovascular disease in treated hypertensive patients. J Hypertens. 1998, 16( suppl 2) : S5.
28. -885.

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A Systematic Review of Losartan versus Valsartan for Essential Hypertension Associated with Hyperuricemia

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