Microalbuminuria and hyperuricemia management are crucial for the integrated management of hypertensive patients. This retrospective post hoc analysis aims to evaluate the optimal allisartan-isoproxil-based combination regimen for hypertensive patients with microalbuminuria or hyperuricemia. A total of 460 hypertensive patients with microalbuminuria and 486 hypertensive patients with hyperuricemia were included in this study. All patients were initially treated with allisartan-isoproxil for 4 weeks. Thereafter, patients with blood pressure (BP) < 140/90 mmHg continued the monotherapy for 8 weeks; patients with BP ≥140/90 mmHg were randomly assigned in a 1:1 ratio to receive allisartan-isoproxil + amlodipine (Group A + C) or allisartan-isoproxil + indapamide (Group A + D) for 8 weeks. The changes of BP, urinary albumin and serum uric acid (UA) were measured. In patients with microalbuminuria, the urinary albumin/creatinine ratio (UACR) significantly decreased by 10.4 mg/g in Group A + C (vs. baseline p = .0035) and 24.2 mg/g in Group A + D (vs baseline p < .0001), intergroup p = NS. In patients with hyperuricemia, serum UA level decreased by 44.5 µmol/L in Group A + C (vs. baseline p = .0003), but increased by 27.2 µmol/L in Group A + D (vs. baseline p = .0167), intergroup p < .0001. The results suggest that for hypertensive patients with microalbuminuria, angiotensin receptor blocker (ARB) + calcium channel blocker (CCB) or ARB+ diuretic both are good choices based on their improvement of microalbuminuria and BP. But for patients with hyperuricemia, ARB + diuretic may further increase the level of UA.

中文翻译：

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阿利沙坦-异丙酯联合降压方案对伴有微量白蛋白尿或高尿酸血症的高血压患者的影响

微量白蛋白尿和高尿酸血症管理对于高血压患者的综合管理至关重要。这项回顾性事后分析旨在评估患有微量白蛋白尿或高尿酸血症的高血压患者的最佳阿利沙坦-异丙酯联合治疗方案。本研究共纳入460例伴有微量白蛋白尿的高血压患者和486例伴有高尿酸血症的高血压患者。所有患者最初均接受阿利沙坦-异丙酯治疗 4 周。此后，血压（BP）<140/90 mmHg的患者继续单一疗法8周；血压≥140/90 mmHg的患者以1:1的比例随机分配接受阿力沙坦-异丙酯+氨氯地平（A+C组）或阿力沙坦-异丙酯+吲达帕胺（A+D组）治疗8周。测量血压、尿白蛋白和血清尿酸（UA）的变化。在微量白蛋白尿患者中，A + C 组的尿白蛋白/肌酐比 (UACR) 显着降低 10.4 mg/g（与基线相比，p  = 0.0035），A + D 组的尿白蛋白/肌酐比值显着降低 24.2 mg/g（与基线相比，p  < .0001)，组间p  = NS。在高尿酸血症患者中，A + C 组的血清 UA 水平降低了 44.5 µmol/L（与基线相比，p  = .0003），但 A + D 组则升高了 27.2 µmol/L（与基线相比，p  = .0167） ，组间p  < .0001。结果提示，对于伴有微量白蛋白尿的高血压患者，血管紧张素受体阻滞剂（ARB）+钙通道阻滞剂（CCB）或ARB+利尿剂对于改善微量白蛋白尿和血压都是不错的选择。但对于高尿酸血症患者，ARB+利尿剂可能会进一步升高UA水平。