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As you know, many if not most antihypertensive agents cause a buildup of uric acid in the body by ertaining uric aciid in the kidneys while excreting salt and water. THe biggest ofenders are the diuretics and these fal into two classes, thiazides and loop diuretics (furosemide (Lasix.) Some evidence exists that thiazide may be the worse offender but both are risky for gout sufferers. But some of us MUST have a diuretic to get effective blood pressure control.
Here's an abstract of a fascinating Japanese study indicating what may be a safe route.
Title;Effects of the uricosuric action by losartan on the patients taking furosemide. Author;YAMATANI AKIMASA(Kokuritsukanazawabyoin Yakuzaika) NOMURA RYOKO(Kokuritsukanazawabyoin Yakuzaika) HAYASHI MAKOTO(Kokuritsukanazawabyoin Yakuzaika) MORI YUKIO(Kokuritsukanazawabyoin Yakuzaika) SUZUKI TATSUO(Kokuritsukanazawabyoin Yakuzaika) YOSHIMURA MITSUHIRO(Kokuritsukanazawabyoin Yakuzaika) Journal Title;Japanese Journal of National Medical Services Journal Code:F0707A ISSN:0021-1699 VOL.56;NO.6;PAGE.327-330(2002) Figure&Table&Reference;FIG.3, REF.6 Pub. Country;Japan Language;Japanese Abstract;Angiotensin II receptor antagonist losartan potassium is demonstrated to have uricosuric effect. We investigated the usefulness of the uricosuric action in the combination therapy using losartan potassium, and furosemide increase serum uric acid concentration. Forty-nine patients with normal renal function and not having any drugs influenced on serum uric acid concentration, were randomly devised into 4 groups; F group who take furosemide monotherapy, FL group who take furosemide and losartan simultaneously, L group who take losartan monotherapy, F.RAR.L group who taking furosemide followed by losartan. As for 4 groups the serum uric acid concentration and change rate were compared of around the losartan and furosemide intake. As a result change rate of F group and FL group was increased 33.3%,21.3%, respectively. Change rate of F group was increased than FL group: however, there was no significant difference between the two groups. Change rate of L group and F.RAR.L group was decreased 2.2%,15.0%,respectively. Change rate of F.RAR.L group decreased significantly than the other groups(non pared t-test). These results suggested that uricosuric effects of losartan might a meliorated the uric acid retention effect of furosemide therapy. (author abst.)
I take BOTH of these agents and thus I will adjust my dosing to the “F.RAR.L group” in order to get a 15 % DROP in my serum uric acid rather than a rise. I HAD been taking both together and more recently taking the losartan (Cozaar) first…a method they didn't study. SOme may find this a bit erudite but for those in need of a good antihypertensive treatment, this may be the cat's meow (showing my age.)
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