From the Guidelines
Losartan is the recommended blood pressure medication that also helps with gout, due to its uricosuric effect, which helps the kidneys eliminate uric acid more effectively, as supported by the most recent and highest quality study 1. This medication belongs to the angiotensin II receptor blocker (ARB) class and has been shown to lower uric acid levels in the blood, which is beneficial for gout management. The typical dosage for losartan ranges from 25-100 mg daily, with most patients starting at 50 mg once daily for both blood pressure and gout benefits. Some key points to consider when using losartan for gout management include:
- Losartan has a uricosuric effect, meaning it helps the kidneys eliminate uric acid more effectively, which can help reduce uric acid levels in the blood 1.
- Unlike some other blood pressure medications like thiazide diuretics (such as hydrochlorothiazide) which can actually increase uric acid levels and potentially worsen gout, losartan is a valuable option for patients with both hypertension and gout or high uric acid levels 1.
- While losartan can help reduce uric acid levels, patients with active gout attacks may still need specific gout medications like colchicine, NSAIDs, or allopurinol for acute treatment or long-term management 1. It's also important to note that the American College of Rheumatology guideline for the management of gout conditionally recommends choosing losartan preferentially as an antihypertensive agent when feasible for patients with gout, regardless of disease activity 1.
From the Research
Blood Pressure Medication for Gout
- Losartan, an angiotensin II receptor blocker (ARB), has been shown to significantly lower uric acid levels and is recommended for patients with gout 2, 3.
- Studies have demonstrated that losartan reduces serum uric acid levels, making it a beneficial treatment option for patients with hyperuricemia and gout 2, 4.
- The addition of losartan to a treatment regimen or switching to losartan as an antihypertensive agent is recommended for patients with gout due to its uricosuric properties 3.
- Losartan has been found to be effective in lowering blood pressure and is well-tolerated in patients with hypertension, including those with renal impairment or heart failure 5, 6.
- Losartan's ability to increase uric acid secretion and lower plasma uric acid levels may be beneficial when combined with a thiazide diuretic, but may also lead to uric acid stone formation and nephropathy 5.