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Lack of effect of hydrocholorthiazide on total cholesterol
1Department of Medicine, University of Mississippi Medical Center, Jackson 39216-4505.
Insights
Hydrochlorothiazide did not adversely affect total cholesterol in Korean hypertensive patients. Dietary fat reduction further lowered cholesterol, regardless of diuretic use.
Area of Science:
- Cardiology
- Pharmacology
- Public Health
Background:
- Hypertension is a global health concern.
- Managing blood pressure often involves pharmacotherapy.
- Assessing the impact of antihypertensives on lipid profiles is crucial.
Purpose of the Study:
- To evaluate the effect of hydrochlorothiazide on total cholesterol levels in hypertensive patients.
- To determine if hydrochlorothiazide influences the impact of dietary fat reduction on cholesterol.
- To investigate cholesterol changes in a Korean population with a low-fat diet.
Main Methods:
- Prospective study of 618 hypertensive subjects in Korea.
- Measurement of baseline and follow-up (14 months) total cholesterol and blood pressure.
- Comparison of cholesterol changes between hydrochlorothiazide users and non-users.
- Analysis of cholesterol changes in patients advised to reduce saturated fat intake.
Main Results:
- Hydrochlorothiazide therapy (n=436) showed a mean total cholesterol decrease of 8 mg/dL.
- Patients not on diuretics (n=182) had an identical mean decrease of 8 mg/dL.
- Patients on a low-fat diet with hydrochlorothiazide (n=180) experienced a significant reduction (-24 mg/dL).
- Patients on a low-fat diet without diuretics (n=71) also showed a significant reduction (-22 mg/dL).
- No significant cholesterol change was observed in either group with baseline cholesterol <= 200 mg/dL.
Conclusions:
- Low-dose hydrochlorothiazide did not adversely affect total cholesterol in this Korean cohort.
- Dietary saturated fat reduction effectively lowered total cholesterol, independent of hydrochlorothiazide use.
- Hydrochlorothiazide and other agents did not impede the benefits of dietary intervention on cholesterol levels.
Abstract:
To determine the effect of hydrochlorothiazide on total cholesterol, baseline total cholesterol and blood pressure were determined in 618 hypertensive subjects in a hypertension clinic in Pusan, Korea. After 12-24 months (mean follow-up time 14 months), total cholesterol and blood pressure measurements were repeated. In the group whose therapy included hydrochlorothiazide (n = 436), total cholesterol fell by 8 +/- 39 mg/dL. Those not treated with a diuretic (n = 182) had an identical fall in total cholesterol of 8 +/- 42 mg/dL (P < 0.001 for change from baseline). Patients with a baseline total cholesterol > 200 mg/dL were asked to reduce intake of saturated fat. Change in total cholesterol for 180 patients on this diet and hydrochlorothiazide was -24 +/- 31 mg/dL (P < 0.0001); for 71 patients on the diet and non-diuretic therapy, change was -22 +/- 35 mg/dL (P < 0.0001). There was no change in total cholesterol in either drug group for those with a baseline value < or = 200 mg/dL. It is concluded that in this group of Korean patients on a relatively low-fat diet, a low dose of hydrochlorothiazide had no adverse effect on total cholesterol at 14 months, and hydrochlorothiazide nor other agents prevented a beneficial effect of further reduction of saturated fat on total cholesterol.