[Metabolic effects of chlorothiazide and propranolol on essential hypertension--a double-blind, cross-over design clinical trial].
Several studies have shown that antihypertensive drugs therapy could reduce morbidity and mortality of hypertension related complication such as stroke, congestive heart failure and renal failure, but there was no significant reduction of coronary heart disease. The benefit of the treatment on morbidity and mortality may be counterbalanced by adversed metabolic effects of long-term therapy. The purpose of this study is to evaluate the blood pressure-lowering and adverse metabolic effects of chlorothiazide and propranolol monotherapy. A double-blind, cross-over design clinical trial was performed for 42 cases (22 males and 20 females) with the mean age of 52 (from 30 to 59 years old). After 2 weeks run-in period, the patients were assigned to group A and B with age and sex stratification. Chlorothiazide and propranolol were given for 12 weeks in alternative with 2 weeks placebo washout period. Our studies have shown that, chlorothiazide and propranolol could reduce both systolic and diastolic blood pressure significantly. But they also associated with adverse metabolic effects. Serum uric acid and triglyceride increased and decreased the concentration of high density lipoprotein cholesterol (HDL-C). Those changes could counterbalance the benefit of blood pressure-lowering effect of antihypertension. Carefully monitoring the adverse metabolic effects closely is necessary in therapy with these drugs.
Chu
N F
NF
Department of Internal Medicine, Tri-Service General Hospital, NationalDefense Medical Center.
Wang
D J
DJ
Chen
L M
LM
Ding
Y A
YA
Shieh
S M
SM
Sung
P K
PK
D000328:Adult; D001794:Blood Pressure / Q000187:drug effects; D002740:Chlorothiazide / Q000494:pharmacology* / Q000627:therapeutic use; D004311:Double-Blind Method; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000378:metabolism; D008297:Male; D008660:Metabolism / Q000187:drug effects; D008875:Middle Aged; D011433:Propranolol / Q000494:pharmacology* / Q000627:therapeutic use
D002740:Chlorothiazide; D011433:Propranolol