Lipid profile during antihypertensive treatment. The SLIP Study Group. Study on Lipids with Isoptin Press

Some antihypertensive drugs adversely affect the plasma lipid profile, and this has to be taken into account when choosing treatment for hypertension because it may offset the beneficial blood pressure-lowering effect of these agents. In this study, the long term effects of verapamil sustained release (SR) 240mg daily and enalapril 20mg daily on plasma lipid levels were investigated in 931 patients with mild to moderate hypertension. Patients whose blood pressure was not effectively lowered after at least 1 month of monotherapy had either enalapril 20mg once daily added to their verapamil treatment or hydrochlorothiazide 12.5mg once daily added to their enalapril treatment. Blood pressure and lipid profile were assessed before and after 6 months of treatment. Of 864 evaluable patients, 563 patients (65.1%) were successfully treated with monotherapy and 220 patients (25.5%) required combination therapy. A total of 81 patients withdrew from the trial. Systolic and diastolic blood pressure were significantly reduced by treatment with either verapamil or enalapril, and heart rate was reduced slightly, but significantly, by both treatments. Total cholesterol, triglycerides and low density lipoprotein were significantly reduced by both treatments. High density lipoprotein levels were significantly increased in verapamil recipients, but not in enalapril recipients. Adverse effects occurred in 37 (3.9%) patients receiving verapamil SR and 25 (2.7%) patients receiving enalapril. In conclusion, long term treatment with the antihypertensive agents verapamil and enalapril, alone or in combination regimens, significantly improved the plasma lipid profile. Verapamil SR had the most beneficial effect on plasma lipid levels.