Skip to main content
Canadian Medical Association Journal logoLink to Canadian Medical Association Journal
. 1978 May 6;118(9):1074–1078.

Treatment of arterial hypertension with tienilic acid, a new diuretic with uricosuric properties.

G Lemieux, M Beauchemin, A Gougoux, P Vinay
PMCID: PMC1818732  PMID: 25707

Abstract

Tienilic acid--2,3-dichloro-4-(2-thienyl-carbonyl)phenoxyacetic acid--is a new diuretic with uricosuric properties. Nineteen patients with moderate arterial hypertension were treated for 5 consecutive weeks in a randomized fashion in a double-blind study with either tienilic acid or hydrochlorothiazide. Blood pressure was significantly reduced and to the same degree with both drugs. In 7 of the 11 patients receiving tienilic acid the daily dose was increased from 250 to 500 mg after 2 weeks, and in 2 of the 8 patients taking hydrochlorothiazide the daily dose was increased from 50 to 100 mg. Because of the potent uricosuric action of tienilic acid the mean serum urate concentration decreased from 6.3 to 3.3 mg/dL in the patients taking the drug. In contrast, the patients receiving hydrochlorothiazide the mean serum urate concentration increased from 6.1 to 7.8 mg/dL. Moderate hypokalemia of almost identical degree (mean serum potassium values 3.6 and 3.5 mmol/L) and mild metabolic alkalosis were observed in both groups. Tienilic acid had a marked hypocalciuric effect, which was of the same magnitude as the observed with hydrochlorothiazide. During the 5 weeks of treatment no significant change in renal or liver function was observed in either group. There were no hematologic complications and the drug was remarkably well tolerated. Tienilic acid, because of its unique character as a diuretic, hypouricemic and antihypertensive agent, should become the preferred drug for the treatment of arterial hypertension.

Full text

PDF
1074

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. ARONOFF A., BARKUM H. Hyperuricemia and acute gouty arthritis precipitated by thiazide derivatives. Can Med Assoc J. 1961 May 27;84:1181–1186. [PMC free article] [PubMed] [Google Scholar]
  2. AYVAZIAN J. H., AYVAZIAN L. F. A study of the hyperuricemia induced by hydrochlorothiazide and acetazolamide separately and in combination. J Clin Invest. 1961 Nov;40:1961–1966. doi: 10.1172/JCI104421. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Benedek T. G. Correlations of serum uric acid and lipid concentrations in normal, gouty, and atherosclerotic men. Ann Intern Med. 1967 May;66(5):851–861. doi: 10.7326/0003-4819-66-5-851. [DOI] [PubMed] [Google Scholar]
  4. Breckenridge A. Hypertension and hyperuricaemia. Lancet. 1966 Jan 1;1(7427):15–18. doi: 10.1016/s0140-6736(66)90005-5. [DOI] [PubMed] [Google Scholar]
  5. Cannon P. J., Stason W. B., Demartini F. E., Sommers S. C., Laragh J. H. Hyperuricemia in primary and renal hypertension. N Engl J Med. 1966 Sep 1;275(9):457–464. doi: 10.1056/NEJM196609012750902. [DOI] [PubMed] [Google Scholar]
  6. Fessel W. J., Siegelaub A. B., Johnson E. S. Correlates and consequences of asymptomatic hyperuricemia. Arch Intern Med. 1973 Jul;132(1):44–54. [PubMed] [Google Scholar]
  7. GERTLER M. M., GARN S. M., LEVINE S. A. Serum uric acid in relation to age and physique in health and in coronary heart disease. Ann Intern Med. 1951 Jun;34(6):1421–1431. doi: 10.7326/0003-4819-34-6-1421. [DOI] [PubMed] [Google Scholar]
  8. Garrick R., Ewan C. E., Bauer G. E., Neale F. C. Serum uric acid in normal and hypertensive Australian subjects. Aust N Z J Med. 1972 Nov;2(4):351–356. doi: 10.1111/j.1445-5994.1972.tb03936.x. [DOI] [PubMed] [Google Scholar]
  9. Klinenberg J. R., Gonick H. C., Dornfeld L. Renal function abnormalities in patients with asymptomatic hyperuricemia. Arthritis Rheum. 1975 Nov-Dec;18(6 Suppl):725–730. doi: 10.1002/art.1780180714. [DOI] [PubMed] [Google Scholar]
  10. Krízek V. Serum uric acid in relation to body weight. Ann Rheum Dis. 1966 Sep;25(5):456–458. [PMC free article] [PubMed] [Google Scholar]
  11. Laragh J. H., Cannon P. J., Stason W. B., Heinemann H. O. Physiologic and clincical observations on furosemide and ethacrynic acid. Ann N Y Acad Sci. 1966 Nov 22;139(2):453–465. doi: 10.1111/j.1749-6632.1966.tb41219.x. [DOI] [PubMed] [Google Scholar]
  12. Lemieux G., Kiss A., Vinay P., Gougoux A. Nature of the uricosuric effect of tienilic acid, a new diuretic. Kidney Int. 1977 Aug;12(2):104–114. doi: 10.1038/ki.1977.87. [DOI] [PubMed] [Google Scholar]
  13. Myers A. R., Epstein F. H., Dodge H. J., Mikkelsen W. M. The relationship of serum uric acid to risk factors in coronary heart disease. Am J Med. 1968 Oct;45(4):520–528. doi: 10.1016/0002-9343(68)90168-x. [DOI] [PubMed] [Google Scholar]
  14. Nemati M., Kyle M. C., Freis E. D. Clinical study of ticrynafen. A new diuretic, antihypertensive, and uricosuric agent. JAMA. 1977 Feb 14;237(7):652–656. [PubMed] [Google Scholar]

Articles from Canadian Medical Association Journal are provided here courtesy of Canadian Medical Association

RESOURCES