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[Biochemical plasma changes in essential hypertension patients treated for a year]
Insights
Certain antihypertensive drugs, atenolol and a hydrochlorothiazide combination, negatively impact cholesterol and metabolic profiles in hypertension patients. Captopril showed no adverse metabolic effects, while nifedipine had minimal impact.
Area of Science:
- Cardiology
- Pharmacology
- Metabolic Medicine
Background:
- Essential hypertension management often involves multiple drug classes.
- Antihypertensive medications can have diverse systemic effects beyond blood pressure control.
- Understanding drug-induced metabolic alterations is crucial for long-term patient health.
Purpose of the Study:
- To prospectively assess metabolic alterations caused by common antihypertensive drugs.
- To compare the metabolic side effect profiles of atenolol, amiloride/hydrochlorothiazide, nifedipine retard, and captopril.
- To evaluate changes in lipid profiles, glucose levels, and other biochemical markers after one month of treatment.
Main Methods:
- 40 patients with essential hypertension were divided into four groups.
- Group 1: Atenolol (100 mg/day). Group 2: Amiloride/Hydrochlorothiazide (5mg/50mg, 4 tablets/week). Group 3: Nifedipine retard (40 mg/day). Group 4: Captopril (50 mg/day).
- Biochemical parameters (lipids, glucose, uric acid, electrolytes), blood pressure, pulse rate, and body weight were measured before and after one month.
Main Results:
- Atenolol and amiloride/hydrochlorothiazide significantly increased total cholesterol and decreased HDL-cholesterol.
- Amiloride/hydrochlorothiazide group showed significant increases in uric acid, glycemia, and triglycerides.
- No significant adverse metabolic changes were observed with captopril; nifedipine retard showed minimal effects. Blood pressure was best controlled in groups 1, 3, and 4.
Conclusions:
- Atenolol and amiloride/hydrochlorothiazide pose risks for adverse metabolic changes in hypertensive patients.
- Captopril appears to be metabolically neutral, offering a favorable option for hypertension management.
- Close monitoring of metabolic parameters is essential when initiating or continuing certain antihypertensive therapies.
Abstract:
The possibility that certain antihypertensive drugs produce metabolic alterations in patients with hypertension treated during one year, has been prospectively assessed in 40 patients with essential hypertension with matched age and blood pressure readings. Four groups (Gr) of 10 patients each were studied. Group 1 received 100 mg/day of atenolol (AT), group 2 received 5 mg of amiloride and 50 mg of hydrochlorothiazide (4 tablets per week), group 3 received 40 mg/day of nifedipine retard (NF) and group 4 received 50 mg/day of captopril (CP). The parameters studied prior and after one month of treatment were the following: urea, creatinine, uric acid, Na+, K+, Ca+, total cholesterol, HDL-cholesterol, triglycerides, glycemia, blood pressure (BP), pulse rate (PR) and body weight. Both group 1 and 2 showed significantly increased total cholesterol (p less than 0.001 and p less than 0.01 respectively) as well as decreased HDL levels. In addition, group 2 had significantly increased levels of uric acid, glycemia and triglycerides (p less than 0.01). In the latter groups no significant changes were found within body weight, lipid levels, glycemia, uric acid ruling-out weight gain as a possible cause for these adverse metabolic effects. Pulse rate decreased in group 1. Group 3 pulse rate significantly increased (p less than 0.001) However, no other changes were significant. No significant biochemical or pulse rate readings were found in group 4. BP was best controlled in groups 1, 3 and 4.