Losartan with hctz side effects
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Side Effects of Losartan with Hydrochlorothiazide (HCTZ)
Common Side Effects: Dizziness and Cough
Losartan combined with hydrochlorothiazide (HCTZ) is generally well-tolerated, but some common side effects have been reported. Dizziness is one of the most frequently reported side effects, occurring in about 2.4% of patients, which is slightly higher than the incidence in placebo groups. Additionally, the combination therapy has been associated with a significant reduction in the occurrence of cough compared to other antihypertensive treatments like enalapril/HCTZ.
Metabolic Effects: Uric Acid Levels
One notable metabolic side effect of losartan/HCTZ is its impact on uric acid levels. Unlike enalapril/HCTZ, which increases serum uric acid levels, losartan/HCTZ does not significantly alter these levels. In fact, losartan has been shown to decrease plasma uric acid levels due to its inhibitory action on uric acid reabsorption via URAT-1, making it a preferable option for patients with hyperuricemia or chronic kidney disease.
Quality of Life and Exercise Tolerance
Losartan/HCTZ has been shown to improve exercise tolerance and quality of life in patients with left ventricular diastolic dysfunction and hypertensive responses to exercise. Over a 6-month period, patients treated with losartan/HCTZ experienced significant improvements in exercise time and quality of life metrics compared to those treated with HCTZ alone.
Blood Pressure Control and Tolerability
The combination of losartan and HCTZ is effective in reducing both systolic and diastolic blood pressure. Studies have shown that this combination therapy is as effective as other antihypertensive treatments like amlodipine but with fewer side effects such as swelling and edema. Additionally, the combination therapy has been found to be effective in obese patients with hypertension, showing significant reductions in blood pressure without notable adverse effects.
Long-term Safety
Long-term studies have demonstrated that losartan/HCTZ is safe and effective for up to one year. In Japanese patients with hypertension uncontrolled by ARBs or ACE inhibitors, the combination therapy maintained significant blood pressure reductions and was well-tolerated, with only 11% of patients reporting clinical or laboratory adverse events.
Comparative Efficacy
When compared to other combination therapies like bisoprolol/HCTZ, losartan/HCTZ has shown a more favorable profile in terms of reducing central systolic blood pressure and having a less negative impact on arterial stiffness and heart rate. This makes losartan/HCTZ a more suitable option for patients requiring long-term antihypertensive therapy.
Conclusion
Losartan combined with hydrochlorothiazide is an effective and generally well-tolerated treatment for hypertension. It offers significant benefits in terms of blood pressure control, exercise tolerance, and quality of life, with fewer side effects compared to other antihypertensive combinations. Its favorable impact on uric acid levels and long-term safety profile make it a viable option for patients with additional metabolic concerns.
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