TY - JOUR
T1 - The effect of losartan and losartan/hydrochlorothiazide fixed-combination on magnesium, zinc, and nitric oxide metabolism in hypertensive patients
T2 - A prospective open-label study
AU - Koren-Michowitz, Maya
AU - Dishy, Victor
AU - Zaidenstein, Ronit
AU - Yona, Orit
AU - Berman, Sylvia
AU - Weissgarten, Joshua
AU - Golik, Ahuva
N1 - Funding Information:
This study was sponsored in part by Merck Sharp & Dohme, Israel.
PY - 2005/3
Y1 - 2005/3
N2 - Background: Thiazide diuretics and angiotensin-converting enzyme inhibitors can cause excessive urinary zinc (Zn) loss and Zn depletion. Thiazides may also induce magnesium (Mg) deficiency, which may exacerbate hypertension. Data on the effects of angiotensin receptor blockers on Zn and Mg homeostasis are scarce. Methods: Seventeen hypertensive patients were studied (ten men and seven women, age 50 ± 3 years, blood pressure 158 ± 5 / 95 ± 3 mm Hg). Patients were treated with losartan 50 mg/day for 4 weeks followed by a fixed combination of 50 mg losartan and 12.5 mg hydrochlorothiazide for 4 weeks more. Blood and 24-h urine were collected at baseline and after each study period. Zinc and Mg levels were measured in serum, urine, and peripheral blood mononuclear cells. Nitric oxide metabolites were measured in urine. Results: Treatment with losartan resulted in a significant increase in the urinary Zn/creatinine ratio (from 0.020 ± 0.004 μg/mg to 0.034 ± 0.005 μg/mg, P =. 02), which was further increased by the losartan/ hydrochlorothiazide combination (from 0.034 ± 0.005 μg/mg to 0.053 ± 0.008 μg/mg, P =. 03). Serum Zn levels were significantly decreased after losartan/hydrochlorothiazide (from 80.0 ± 4.0 μg/dL at baseline to 74.0 ± 3.0 μg/dL, P =. 007). Peripheral blood mononuclear Zn concentrations were decreased also, but this was not statistically significant. Serum, urinary, and peripheral blood mononuclear Mg levels were not significantly affected by treatment. Nitric oxide urinary metabolites were unchanged throughout the study. Conclusions: Treatment with losartan causes an increase in urinary Zn excretion and induces Zn deficiency in patients with hypertension. The addition of hydrochlorothiazide has an additive effect. Magnesium and nitric oxide metabolism are not affected by either treatment.
AB - Background: Thiazide diuretics and angiotensin-converting enzyme inhibitors can cause excessive urinary zinc (Zn) loss and Zn depletion. Thiazides may also induce magnesium (Mg) deficiency, which may exacerbate hypertension. Data on the effects of angiotensin receptor blockers on Zn and Mg homeostasis are scarce. Methods: Seventeen hypertensive patients were studied (ten men and seven women, age 50 ± 3 years, blood pressure 158 ± 5 / 95 ± 3 mm Hg). Patients were treated with losartan 50 mg/day for 4 weeks followed by a fixed combination of 50 mg losartan and 12.5 mg hydrochlorothiazide for 4 weeks more. Blood and 24-h urine were collected at baseline and after each study period. Zinc and Mg levels were measured in serum, urine, and peripheral blood mononuclear cells. Nitric oxide metabolites were measured in urine. Results: Treatment with losartan resulted in a significant increase in the urinary Zn/creatinine ratio (from 0.020 ± 0.004 μg/mg to 0.034 ± 0.005 μg/mg, P =. 02), which was further increased by the losartan/ hydrochlorothiazide combination (from 0.034 ± 0.005 μg/mg to 0.053 ± 0.008 μg/mg, P =. 03). Serum Zn levels were significantly decreased after losartan/hydrochlorothiazide (from 80.0 ± 4.0 μg/dL at baseline to 74.0 ± 3.0 μg/dL, P =. 007). Peripheral blood mononuclear Zn concentrations were decreased also, but this was not statistically significant. Serum, urinary, and peripheral blood mononuclear Mg levels were not significantly affected by treatment. Nitric oxide urinary metabolites were unchanged throughout the study. Conclusions: Treatment with losartan causes an increase in urinary Zn excretion and induces Zn deficiency in patients with hypertension. The addition of hydrochlorothiazide has an additive effect. Magnesium and nitric oxide metabolism are not affected by either treatment.
KW - Hypertension
KW - Losartan
KW - Magnesium
KW - Nitric oxide
KW - Thiazides
KW - Zinc
UR - http://www.scopus.com/inward/record.url?scp=15744393208&partnerID=8YFLogxK
U2 - 10.1016/j.amjhyper.2004.09.019
DO - 10.1016/j.amjhyper.2004.09.019
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C2 - 15797654
AN - SCOPUS:15744393208
SN - 0895-7061
VL - 18
SP - 358
EP - 363
JO - American Journal of Hypertension
JF - American Journal of Hypertension
IS - 3
ER -