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Serum lipoproteins during antihypertensive therapy with beta blockers and diuretics: a controlled long-term
Insights
Atenolol and hydrochlorothiazide, used for hypertension, differently impact serum lipoproteins. Atenolol lowers HDL cholesterol, while hydrochlorothiazide raises triglycerides and LDL cholesterol over time.
Area of Science:
- Cardiovascular Pharmacology
- Clinical Lipidology
- Hypertension Management
Background:
- Essential hypertension is a common cardiovascular risk factor.
- Lipoprotein profiles are critical indicators of cardiovascular health.
- Understanding medication effects on lipids is vital for patient management.
Purpose of the Study:
- To investigate the long-term influence of atenolol and hydrochlorothiazide on serum lipoproteins in hypertensive men.
- To compare the differential effects of these two common antihypertensive agents on lipid profiles.
Main Methods:
- A randomized, prospective study involving 68 men with essential hypertension.
- Monitoring of cholesterol, HDL cholesterol, LDL cholesterol, triglycerides, apolipoproteins AI, and B up to 42 months.
- Analysis of changes in lipoprotein parameters following treatment with atenolol and hydrochlorothiazide.
Main Results:
- Atenolol significantly decreased HDL cholesterol and increased triglycerides from 6 to 42 months.
- Hydrochlorothiazide significantly increased triglycerides, LDL cholesterol, and total cholesterol from 12 to 42 months.
- Adverse lipoprotein changes were dose-dependent with atenolol but not hydrochlorothiazide.
Conclusions:
- Both atenolol and hydrochlorothiazide exert distinct adverse effects on serum lipoproteins during long-term administration.
- Further research is needed to ascertain if these lipid alterations mitigate the cardiovascular benefits of blood pressure control in hypertensive patients.
Abstract:
The influence of hydrochlorothiazide and atenolol on serum lipoproteins was investigated in a randomized, prospective study on 68 men with essential hypertension. Cholesterol, high density lipoprotein (HDL) cholesterol, low density lipoprotein (LDH) cholesterol, triglycerides, and the apolipoproteins AI and B were followed up to 42 months after starting therapy. Following atenolol serum (HDL) cholesterol decreased and serum triglycerides increased significantly (p less than 0.01) from 6 to 42 months. After hydrochlorothiazide serum triglycerides, LDL cholesterol and total cholesterol all increased significantly (p less than 0.01) from 12 to 42 months. The changes were more pronounced under higher doses with beta blockade, but not with diuretics. Thus, both atenolol and hydrochlorothiazide have adverse but different effects on serum lipoproteins after long-term administration. Continuing investigation is necessary to determine whether these side effects decrease the benefit of blood pressure reduction in patients with hypertension.