Biochemical cardiac risk factors during diuretic therapy

The effects of six weeks of treatment with fixed doses of the diuretics chlorthalidone and ticrynafen on serum total cholesterol, low density lipoproteins, high density lipoproteins, triglycerides and other biochemical parameters were studied in 24 hypertensive patients. Chlorthalidone increased total serum cholesterol by 40 +/- 11 (SEM) mg/dl (P less than 0.01) and triglycerides by 80 +/- 30 mg/dl (P less than 0.05). The increase of 16 +/- 12 mg/dl in low density lipoproteins and the decrease of 5 +/- 6 mg/dl in high density lipoproteins induced by this drug were not significant. An investigational uricosuric diuretic, ticrynafen, caused no significant changes in any of the serum lipid concentrations measured. Fasting blood glucose levels were elevated, but not significantly, by both diuretics. Serum uric acid concentrations tended to increase in patients given chlorthalidone while ticrynafen treatment decreased uric acid levels by 2.9 +/- 1.4 mg/dl (P less than 0.01). The elevations induced by chlorthalidone in serum lipid levels may partially counteract the potential benefits of its antihypertensive effects.