The metabolic effects of diuretics and other antihypertensive drugs: a perspective as of 1989.
Active treatment has produced a dramatic decline in the 'mechanical' complications of hypertension (haemorrhagic stroke, congestive heart failure, renal failure, and aortic dissection) but has had no effect on the 'thrombotic' complications (thrombotic stroke, and myocardial infarction). There is a growing body of opinion that this failure is related to changes in the metabolism of lipoproteins and carbohydrates induced by anti-hypertensive drugs, which actively counteract the beneficial effects of a lowered blood pressure. The literature on this subject is extensive, but the results are inconclusive and much remains to be learned. In the light of present knowledge, it would appear to be prudent to choose anti-hypertensive drugs with care, concentrating upon proven agents which produce minimal biochemical disturbances, rather than using drugs which are known to have marked effects on lipoprotein metabolism.
Raftery
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EB
Cardiology Department, Northwick Park Hospital, Harrow, U.K.
D000319:Adrenergic beta-Antagonists / Q000494:pharmacology; D000959:Antihypertensive Agents / Q000494:pharmacology*; D050260:Carbohydrate Metabolism; D004232:Diuretics / Q000494:pharmacology*; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D008074:Lipoproteins / Q000187:drug effects / Q000378:metabolism*; D014527:Uric Acid / Q000097:blood; D014882:Water-Electrolyte Balance / Q000187:drug effects
D000319:Adrenergic beta-Antagonists; D000959:Antihypertensive Agents; D004232:Diuretics; D008074:Lipoproteins; D014527:Uric Acid