Long-term effects of doxazosin and atenolol on serum lipids and blood pressure in hypertensive smokers.
On the basis of a 1-year double-blind comparative study of doxazosin and atenolol in hypertensive patients, we have previously described sustained and significantly different drug effects on the blood lipid profile. The present paper presents a retrospective analysis of the smoking subgroups for each drug regimen, for both the original 12-month double-blind period and for a further 12-month open-label period. The changes in blood lipids were qualitatively and quantitatively similar in both the smoking subgroup and in the full study population (smokers and non-smokers). In the hypertensive smokers doxazosin increased high-density lipoprotein (HDL) cholesterol (+9.4%) and decreased triglycerides (-10.9%) whereas atenolol had the opposite effect, decreasing HDL cholesterol (-5.6%) and increasing triglycerides (+20.7%). The antihypertensive effects of doxazosin (n = 24) and atenolol (n = 23) were comparable over 24 months of treatment. Eighteen (75%) doxazosin and 17 (73.9%) atenolol patients reached the blood pressure goal (sitting diastolic blood pressure less than or equal to 90 mmHg with at least a 5-mmHg reduction, or a greater than or equal to 10-mmHg reduction from baseline). As a consequence of the lowered blood pressure and favourable lipid changes, doxazosin decreased the risk of coronary heart disease (as calculated from the Framingham risk equation) by -24.4% (P less than 0.05). However, the calculated risk was not significantly reduced by atenolol (-2.1%). It is concluded that the smoking status of the patient has no obvious implications for the safety, efficacy or metabolic effects of doxazosin.
Talseth
T
T
Department of Medicine, Rikshospitalet, National Hospital, Oslo, Norway.
Westlie
L
L
Daae
L N
LN
D000293:Adolescent; D000317:Adrenergic alpha-Antagonists / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D000328:Adult; D000368:Aged; D001262:Atenolol / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D004311:Double-Blind Method; D017292:Doxazosin; D005260:Female; D006439:Hemodynamics / Q000187:drug effects*; D006801:Humans; D006973:Hypertension / Q000097:blood / Q000150:complications / Q000188:drug therapy*; D008055:Lipids / Q000097:blood*; D008297:Male; D008875:Middle Aged; D011224:Prazosin / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000494:pharmacology / Q000627:therapeutic use; D012189:Retrospective Studies; D012907:Smoking / Q000097:blood / Q000188:drug therapy* / Q000503:physiopathology
D000317:Adrenergic alpha-Antagonists; D008055:Lipids; D001262:Atenolol; D017292:Doxazosin; D011224:Prazosin