Effects of oral antihypertensive agents on blood lipid levels.
The Lipid Research Clinic trials established conclusively that lowering serum cholesterol reduces the incidence of coronary heart disease. Yet a number of clinical trials have demonstrated that many pharmacological agents commonly used to lower blood pressure also adversely affect serum lipid levels. Recent studies of prolonged use of beta-blockers and diuretics have failed to show that these agents have any clear primary preventive effect on coronary heart disease; in a few cases, these agents were believed to pose a greater risk of coronary heart disease than no antihypertensive treatment at all. These observations suggest that a reappraisal of current therapeutic schemes is in order. Because coronary heart disease is known to have many causes, primary preventive therapy must logically go beyond the relatively simple goal of lowering blood pressure. The metabolic effects of antihypertensive drugs, particularly on blood lipids, should also be taken into account. These effects could be of special clinical significance in relatively young patients, for whom the long-term risk of developing coronary heart disease is of major concern. This review discusses recent clinical trials examining the effects on lipids of diuretics, beta-blockers, and selective alpha-adrenoceptor blocking agents.
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D000284:Administration, Oral; D000319:Adrenergic beta-Antagonists / Q000097:blood / Q000494:pharmacology; D000368:Aged; D000959:Antihypertensive Agents / Q000008:administration & dosage* / Q000097:blood / Q000627:therapeutic use; D001794:Blood Pressure; D002986:Clinical Trials as Topic; D003327:Coronary Disease / Q000097:blood / Q000188:drug therapy / Q000209:etiology / Q000503:physiopathology; D004232:Diuretics / Q000097:blood / Q000494:pharmacology; D004311:Double-Blind Method; D017292:Doxazosin; D006801:Humans; D006937:Hypercholesterolemia / Q000150:complications / Q000188:drug therapy; D006973:Hypertension / Q000150:complications / Q000188:drug therapy / Q000503:physiopathology; D008055:Lipids / Q000097:blood*; D008297:Male; D008875:Middle Aged; D010869:Pindolol / Q000097:blood / Q000494:pharmacology; D011224:Prazosin / Q000031:analogs & derivatives / Q000097:blood / Q000494:pharmacology; D011446:Prospective Studies; D012306:Risk
D000319:Adrenergic beta-Antagonists; D000959:Antihypertensive Agents; D004232:Diuretics; D008055:Lipids; D010869:Pindolol; D017292:Doxazosin; D011224:Prazosin