Pp.13.27: Compare The Two Therapeutic Combinations Of Arb With Diuretic

Objective: Angiotensin Receptor Blocker (ARB) and Calcium Channel Blocker (CCB) were listed as the first choice therapeutic drugs in the Guideline of Japanese Society of Hypertension (JSH) 2012. In JSH guideline, Diuretics (DU) was listed as the second choice drugs which has a side effect to increase the Uric Acid (UA) levels. And previous study showed that upregulating UA was an independent risk factor for cardiovasculardisease. Although the combination therapy ARB with DU is common now, it is not clear the affinity for Hypertensin what the best combination which ARB with which DU. Here, we show that compare the two therapeutic combination Valsartan (VAL) with Hydrochlorothiazide (HCTZ) and Irbesartan (IRB) with Trichlormethiazide (TCTZ). Design and method: 40 patients with essennstial hypertension without diabetes mellitus aged 50 to 80 year old were first prescribe 80 mg VAL, next randomly allocated to VAL with HCTZ or IRB with TCTZ. Blood exams were checkd at before and after 1 month single medication of VAL, and 3 months after changed to ARB with DU. (VAL + HCTZ or IRB + TCTZ, the significant difference between both groups were not seen.) Results: Through an observation period, we did not recognize the significant difference to the blood pressure of both groups. Significant difference was recognized only to the UA level three months after the dosage of ARB with DU, the group using IRB with TCTZ was a low value for significant difference from VAL with HCTZ. Conclusions: Our conclusion was we should have pay attention to UA levels increasing by using of ARB with DU, because upregulating UA was independent risk factor for cardiovascular disease.