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Diuretics and beta-blockers: is there a risk for dyslipidemia?
1Division of Nephrology, University of Maryland School of Medicine, Yale University School of Medicine, New Haven, Connecticut, USA.
Background:
Hypertension is a major risk factor for cardiovascular disease, particularly in combination with other risk factors such as obesity, smoking, diabetes, and dyslipidemia. Effective management of hypertension, even a modest reduction in blood pressure, results in reduced mortality and morbidity from cerebrovascular and cardiovascular disease.
Methods:
Data from clinical trials were examined to assess the effect of low-dose diuretics or beta-blockers on lipoprotein profile.
Results:
Results of numerous clinical trials demonstrate that low doses of thiazides or cardioselective beta-blockers alone or in combination result in minimal changes in lipid profile.
Conclusions:
Low doses of thiazide diuretics or beta-blockers are a safe and effective approach to the management of uncomplicated essential hypertension and have the advantage of an association with an evidence-based reduction in morbidity and mortality in long-term clinical trials. There is little or no evidence that the minimal changes in serum lipid profile associated with use of these drugs have resulted in a negation of the beneficial effects of these agents on blood pressure.