Back to Search
Start Over
The effects of antihypertensive combination therapy on lipid and glucose metabolism: hydrochlorothiazide plus sotalol vs. hydrochlorothiazide plus captopril.
- Source :
-
International journal of clinical pharmacology and therapeutics [Int J Clin Pharmacol Ther] 1997 Jun; Vol. 35 (6), pp. 231-4. - Publication Year :
- 1997
-
Abstract
- Metabolic side-effects of antihypertensive drugs may increase the risk of coronary heart disease despite an adequate blood pressure reduction. Since combinations of different antihypertensive drugs are often necessary and frequently used, we performed a randomized study comparing the effects of a fixed combination of hydrochlorothiazide and sotalol (group A), or hydrochlorothiazide and captopril (group B) on blood pressure and on lipid and glucose metabolism in 40 men with essential hypertension over 1 year. Significant blood pressure reductions (p < 0.001) were achieved in both treatment groups: from 160/105 to 128/88 mmHg in group A (mean doses: hydrochlorothiazide 33 and sotalol 197 mg) and from 162/106 to 135/89 mmHg in group B (hydrochlorothiazide 33 and captopril 64 mg) after 12 months, respectively. No significant changes in body weight were observed in either treatment group. Triglycerides increased (p < 0.05) in both treatment groups (from 183 to 262 mg/dl in A, and from 160 to 196 mg/dl in B) and HDL cholesterol decreased (p < 0.001 and < 0.05) in both groups (from 45.1 to 35.7 mg/dl in A, and from 49.3 to 46.3 mg/dl in B), whereas LDL cholesterol increased significantly (p < 0.05) only in group A from 153 to 164 mg/dl. No significant changes were observed in total cholesterol nor in lipoprotein(a) concentrations in either treatment group. Fasting plasma glucose and hemoglobin A1 increased significantly (p < 0.05) only in group A after 1 year of treatment (from 91.6 to 98.0 mg/dl, and from 6.3 to 6.9%, respectively). Serum levels of creatinine and potassium decreased, and uric acid increased significantly under either combination. Our data show that the diuretic/beta-blocker combination has adverse effects on lipid and glucose metabolism after long-term therapy. The effects of the diuretic/ACE inhibitor combination on lipid metabolism are less pronounced and there are no adverse effects on glucose metabolism. However, the ACE inhibitor component could not completely counteract the metabolic effects of the diuretic. Both combinations have no effects on Lp(a). We conclude that the combination of hydrochlorothiazide with an ACE inhibitor has a better metabolic profile for the treatment of essential hypertension than the combination with a beta-blocker.
- Subjects :
- Adrenergic beta-Antagonists administration & dosage
Adrenergic beta-Antagonists therapeutic use
Adult
Angiotensin-Converting Enzyme Inhibitors administration & dosage
Angiotensin-Converting Enzyme Inhibitors therapeutic use
Antihypertensive Agents administration & dosage
Antihypertensive Agents therapeutic use
Blood Glucose metabolism
Blood Pressure drug effects
Captopril administration & dosage
Captopril pharmacology
Captopril therapeutic use
Diuretics
Drug Therapy, Combination
Hemoglobin A metabolism
Humans
Hydrochlorothiazide administration & dosage
Hydrochlorothiazide pharmacology
Hydrochlorothiazide therapeutic use
Hypertension blood
Hypertension metabolism
Male
Middle Aged
Radioimmunoassay
Sodium Chloride Symporter Inhibitors administration & dosage
Sodium Chloride Symporter Inhibitors therapeutic use
Sotalol administration & dosage
Sotalol pharmacology
Sotalol therapeutic use
Adrenergic beta-Antagonists pharmacology
Angiotensin-Converting Enzyme Inhibitors pharmacology
Antihypertensive Agents pharmacology
Blood Glucose drug effects
Hypertension drug therapy
Lipids blood
Sodium Chloride Symporter Inhibitors pharmacology
Subjects
Details
- Language :
- English
- ISSN :
- 0946-1965
- Volume :
- 35
- Issue :
- 6
- Database :
- MEDLINE
- Journal :
- International journal of clinical pharmacology and therapeutics
- Publication Type :
- Academic Journal
- Accession number :
- 9208337