Metabolic side effects of diuretics and beta-adrenoceptorblockers

A review is made of the metabolic side effects of diuretics and beta-adrenoceptorblockers. The review is based on results from a population study, performed by the author, of women and on a survey of the literature. While diuretics give rise to hypokalemia, which may be of clinical importance, beta-adrenoceptorblockers tend to increase the serum potassium levels. This does not, however, seem to be of clinical significance. Both diuretics and beta-adrenoceptorblockers increase serum uric acid levels. Beta-adrenoceptorblockers increase serum triglycerides, which is not observed when diuretics are used. Total cholesterol in serum is usually not changed either by diuretics or by beta-adrenoceptorblockers. These drugs seem to have no influence on body weight when studied during long-term treatment. A further deterioration of glucose tolerance may be expected in subjects with an initially impaired glucose tolerance when diuretics are administered, while results from studies on glucose tolerance in subjects taking beta-adrenoceptorblockers have been controversial. Diabetes mellitus seems to be more common among subjects on diuretics as well as among subjects on beta-adrenoceptorblockers, but as yet it cannot be stated whether this is an effect of the antihypertensive drugs or of the hypertension per se or of some other factor or factors.