Abstract P114: Effects Of Losartan And The Dash Diet On Serum Urate

Abstract

Background: The DASH diet and losartan each lower blood pressure (BP) and concurrently affect many cardiometabolic biomarkers. Whether these BP-lowering treatments reduce serum urate, a pro-oxidant associated with cardiovascular health and gout, is uncertain. Objective: To determine the independent effects of the DASH diet and losartan on serum urate. Methods: We randomized 55 participants with elevated BP in parallel fashion to the DASH or control diet, the standard American diet. While on their assigned diet, participants were randomized in a two-period cross-over design to losartan or placebo, each for 4-weeks. Serum urate was measured at baseline and at the end of each period. Diets were designed to maintain a constant weight constant. We examined the independent effects of DASH (vs control) or losartan (vs placebo) on serum urate, overall and among those with baseline serum urate ≥6 mg/dL, using generalized estimating equations. Results: Of 55 randomized participants, mean age of participants was 52 years, 58% were women, and 64% were Black. Mean (±SD) baseline SBP/DBP was 146±12/91±9 and mean (±SD) serum urate was 5.2±1.2 mg/dL. Losartan significantly decreased serum urate (overall mean difference -0.23 mg/dL; 95% CI: -0.40, -0.05). The DASH diet did not significantly reduce urate levels overall (mean difference -0.05 mg/dL; 95% CI: -0.39, 0.28), but did decrease levels in participants with elevated baseline urate levels (≥6 mg/dL), with a mean difference of -0.33 mg/dL (95% CI: -0.87, 0.21; P -interaction =0.007 across hyperuricemia groups). Conclusions: In adults with elevated BP, losartan significantly reduced serum urate, while the DASH diet only significantly decreased serum urate among participants with higher urate at baseline. Additional research should explore potential mechanisms, as well as the effects of these treatments on clinical outcomes (e.g. gout).