To explore the clinical efficacy and safety of losartan potassium and hydrochlorothiazide tablets in the treatment of male patients with H-type hypertension complicated with osteoporosis.

Male patients with H-type hypertension complicated with osteoporosis were prospectively and randomly divided into control group and treatment group according to the random number table method. Both groups received conventional basic treatment. The control group was given amlodipine tablets on the basis of basic treatment, with an initial dose of 5 mg once a day (qd). If the blood pressure was not controlled after 2 to 4 weeks of treatment, the dose was adjusted to 10 mg qd. The treatment group was given losartan potassium and hydrochlorothiazide tablets on the basis of basic treatment, with an initial dose of 1 tablet qd. If the blood pressure was not controlled after 2 to 4 weeks of treatment, the dose was adjusted to 2 tablets qd. Both groups were treated for 12 weeks. The blood pressure efficacy, blood pressure monitoring, serum homocysteine (Hcy), cystatin C (CysC), folic acid, bone mineral density, bone metabolism indicators, and inflammatory indicators of the two groups were compared, and safety was evaluated.

A total of 88 patients were included, with 44 patients in the treatment group and 44 patients in the control group. The total effective rates of the treatment group and the control group were 90.91% (40 cases/44 cases) and 86.36% (38 cases/44 cases), respectively (P>0.05). After treatment, the Hcy levels of the treatment group and the control group were (9.28±2.13) and (10.94±2.40) μmol·L^-1, respectively; the CysC levels were (1.24±0.33) and (1.41±0.28) mg·L^-1, respectively; the folic acid levels in the treatment group and control group were (17.64±2.41) and (16.51±2.82) μg·L^-1, the type I collagen C-terminal telopeptide levels were (0.69±0.10) and (0.73±0.11) μg·L^-1, respectively; the osteocalcin levels were (20.81±3.67) and (19.11±2.64) μg·L^-1, respectively; the bone-specific alkaline phosphatase levels were (17.85±2.68) and (16.62±3.03) μg·L^-1, respectively; the alkaline phosphatase levels were (102.56±16.80) and (95.10±16.07) U·L^-1, respectively; the high-sensitivity C-reactive protein levels were (10.45±1.31) and (11.64±1.82) mg·L^-1, respectively; the matrix metalloproteinase-2 levels were (296.23±33.59) and (319.23±42.70) pg·mL^-1, respectively; and the interleukin-10 levels were (19.21±2.79) and (17.42±2.96) ng·mL^-1, respectively. Except folic acid, the differences of above indexes were all statistically significant (P<0.05, P<0.01). In the treatment group, adverse drug reactions included headache, dizziness, nausea and diarrhea; in the control group, adverse drug reactions included lower limb edema, headache, dizziness and gingival swelling. The total incidence of adverse drug reactions in the treatment group and the control group was 11.36% (5 cases/44 cases) and 13.64% (6 cases/44 cases), respectively (P>0.05).

Losartan potassium and hydrochlorothiazide tablets and amlodipine tablets have comparable efficacy and safety. The former showed positive effects on bone metabolism indicators during short-term treatment, and presented a certain positive trend in regulating Hcy, CysC, and inflammatory levels, which may provide a reference for the selection of combined medication regimens for such patients.