Dissertation > Excellent graduate degree dissertation topics show

Effects of Diovan and Co-Diovan on Serum Uric Acid in Essential Hypertension Patients

Author: YaoWenShuang
Tutor: HaoYuMing
School: Hebei Medical University
Course: Internal Medicine
Keywords: Essential hypertension Diovan Co-Diovan Uric acid Blood pressure
CLC: R544.1
Type: Master's thesis
Year: 2007
Downloads: 74
Quote: 0
Read: Download Dissertation

Abstract

Objective: The relationship between hyperuricemia (HUA) and cardiovascular events has always been concerned by people. Many epidemiological and clinical studies also showed that an elevation in circulating serum uric acid was strongly associated with the development of cardiovascular diseases. HUA is an independent and strongly predictor of cardiovascular diseases death and all the other reasons for death. The serum uric acid concentration should be inspected, and the HUA should be intervened in cardiovascular patients, for all these had important clinical significance: it could reduce the outbreaks of cardiovascular event, improve prognosis and elevate the quality of life for the patients.Obesity, hypertension, hyperlipoidemia and alcoholism are all risk factors for HUA. HUA is an independent risk factor for hypertension, and is also associated with increased rates of cardiovascular and cerebrovascular events in hypertension patients. Heart disease and stroke happened more frequently in hypertension patients with high serum uric acid level than those with normal uric acid level. Study discovered that HUA could increase the fatality rate of hypertension patients, cardio- cerebrovascular patients and elderly people. So we should pay attention to the level of serum uric acid when we decreased the blood pressure, especially we should select the drugs which can decrease blood pressure and blood uric acid simultaneous.AngiotensinⅡreceptor antagonists has the effect on hypertension. At the same time it can reverse the ventricular hypertrophy, protect heart function, alleviate ventricular remodeling, protect vein endothelium system and improve renal function of the hypertension patients. Research showed that Losartan (COZAAR) could increase the drainage of uric acid and reduce the serum uric acid concentration in hypertension patients. The curative effect was affirmative. But the effect of Diovan (Valsartan) on serum uric acid has less investigation now.Co-Diovan is the preparation of Valsartan (80mg) in combination with hydrochlorothiazide (Hctz 12.5mg). Diuretic is traditional antihypertensive drug, and it has well curative effect on hypertension. But people have always been concerned about its bad influence on metabolizability for so many years, uric acid included. Investigation indicated that small dosage diuretic could prevent cerebrovascular suddenness, reverse the left ventricular hypertrophy and reduce cardiovascular events, which was better than large dosage. Study also showed that the serum uric acid was significantly decreased by Losartan in combination with small dosage Hctz . But there was no report of the effect of Co-Diovand on uric acid now. The aim of this study is to explore the effect of Diovan and Co-Diovan on serum uric acid in essential hypertension, and to compare the differences between Diovan and Co-Diovan. We also evaluate the security、efficacy and tolerability of Diovan and Co-Diovan in essential hypertension patients. Consequently we can provide the foundation for selecting the effective antihypertensive drugs.Methods: This study is a random、double blind、parallel test. It included 73 essential hypertension (EH) patients measured up. The patients who have been treated beforetime would go through a period of cleanout for two weeks (with the exception of the one who was diagnosed recently and has not been treated). After two weeks the patients whose MSDBP≥95mmHg and<110mmHg were treated with Diovan 80 mg·dˉ1for 4 weeks(single blind import period). After the period of single blind the patients whose blood pressure was not significantly decreased(MSDBP≥95mmHg and<110mmHg) were divided into two groups at random. The two groups were respectively given Diovan 80 mg·dˉ1 and Co-Diovan (Valsartan 80mg/ Hctz 12.5mg) 1 table·dˉ1 for 8 weeks(double blind period). The blood pressure was observed before treatment, at interview 3 and after the period of double blind. All the patients were collected blood when they were fasting and the serum uric acid concentration was measured.Statistical analysis was performed using SPSS 13.0 software package. (P<0.05) was considered significant for all statistical analysis. Self-contrast in each group was compared using Paired-Samples T test. Independent-Samples T Test was performed to determine the differences between every two groups.Results:1 Effects on serum uric acid1.1 No correlation was detected between the level of serum uric acid and age, sex, medical history, blood pressure in EH patients without treatment.1.2 Serum uric acid of the patients taking Diovan for 4 weeks was significantly decreased compared with before treatment, the difference had statistical significance (P=0.012). In the double blind period, level of UA in Diovan group was not changed after treatment for 8 weeks (P=0.93); In Co-Diovan group, UA was increased after treatment but no significance (P=0.058). And the effect of Diovan and Co-Diovan on UA was no significantly difference (P>0.05).2 Effects on blood pressureAfter treatment, both systolic and diastolic blood pressures decreased significantly in two groups (P<0.05). We compared the effect of Diovan and Co-Diovan on BP. The effect of Co-Diovan on SBP was not significantly different from Diovan(P=0.155),but it was better on DBP than Diovan (P=0.04).3 Effects on other biochemistry indexCrea was significantly decreased after the treatment of Diovan for 4 weeks, but the other biochemistry index, such as Na、K、BUN、GLU and CHOL, kept the same(P>0.05). However the other biochemistry index had no evident change after the treatment of Diovan for 8 weeks; And Co-Diovan had no effect on the other biochemistry index (P>0.05).Conclusion:1 1 No correlation was detected between the level of serum uric acid and age, sex, medical history, blood-pressure in EH patients without treatment.2 Diovan and Co-Diovan could effectively control blood pressure of the essential hypertension patients, and the curative effect of Co-Diovan on DBP was better than Diovan.3 Diovan could decrease the serum uric acid concentration of EH patients significantly. Compared Diovan group with Co-Diovan group, the level of serum uric acid had no significantly difference. Diovan combined with small dosage diuretic had no evident influence on uric acid.4 Diovan could decrease the level of Crea in EH patients, but Co-Diovan had no this effect.5 Diovan and Co-Diovan had no effects on the other biochemistry index.In summary, Diovan has well curative effect on hypertension and can improve the metabolizability of uric acid. The patients whose blood pressure not up to bar after the treatment of Diovan took small dosage diuretic (Hctz 12.5mg) simultaneously, then the blood pressure was decreased. The curative effect was reinforced. And it had no evident effect on serum uric acid.

Related Dissertations

CLC: > Medicine, health > Internal Medicine > Heart, blood vessels ( circulatory ) disease > Abnormal blood pressure > Hypertension
© 2012 www.DissertationTopic.Net Mobile