Losartan titration versus diuretic combination in type 2 diabetic patients

Journal of Hypertension
Pedro Luis de Pablos-VelascoLuis M Ruilope

Abstract

We compared the effects of Losartan dose titration to 100 mg versus the addition of 12.5 mg of hydrochlorothiazide, in 90 type 2 diabetic patients with microalbuminuria and blood pressure > 130/85 mmHg, receiving losartan 50 mg as initial treatment during 4 weeks. With the first dose of losartan, systolic (SBP) and diastolic blood pressure (DBP) decreased from 154.5 (152.1-157.5) to 144.4 (141.3-147.5) mmHg (P < 0.001) and from 91.1 (89.4-92.8) to 84.6 (82.8-86.4) mmHg (P < 0.001), with 20 patients attaining the expected goal blood pressure (< 130/85 mmHg); albuminuria decreased from 109.8 (90.5-133.3) to 83.5 (63.6-109.5) mg per 24 h (P = 0.006). Patients not attaining the target blood pressure were randomly allocated to titration or to the combination arm. After an additional 4 weeks, patients titrated exhibited a fall in SBP and DBP from 157.1 (152.7-161.5) to 142.1 (136.4-147.8) mmHg (P < 0.001) and from 92.4 (89.5-95.3) to 83.6 (81.1-86.1) mmHg (P < 0.001); albuminuria decreased from 136.3 (97.8-189.9) to 99.7 (69.3-143.4) mg per 24 h (P = 0.002). In the combination arm, there were similar reductions in SBP and DBP from 155.3 (151.5-159.1) to 139.1 (132.1-146.1) mmHg (P < 0.001) and from 92.1 (89.3-94.9) to 80.9 (77.4-84.4...Continue Reading

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Citations

Aug 22, 2003·Journal of Hypertension. Supplement : Official Journal of the International Society of Hypertension·Giancarlo Viberti
Dec 14, 2007·American Journal of Cardiovascular Drugs : Drugs, Devices, and Other Interventions·David H G Smith
Nov 11, 2009·Expert Review of Cardiovascular Therapy·Gianpaolo ReboldiPaolo Verdecchia
Jul 1, 2004·Expert Review of Cardiovascular Therapy·Norberto PericoGiuseppe Remuzzi

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