Amiloride with or without salbutamol versus placebo: effects on lipoproteins in hypertensive patients treated with timolol-hydrochlorothiazide.
Because thiazides and beta-blockers have adverse effects on lipoproteins, while magnesium repletion (shown to occur with amiloride) and beta 2 agonists improve lipids, we studied the effects of 3 months each of amiloride with and without salbutamol with and without placebo in a 2 X 2 factorial crossover study in which all patients took timolol-hydrochlorothiazide twice daily for 1 year. A total of 118 subjects entered, and 97 patients completed all four crossovers of amiloride + salbutamol, amiloride + placebo, salbutamol + placebo and placebo + placebo. No significant differences were seen among the four study regimens with respect to blood pressure, total cholesterol, triglycerides or high-density lipoproteins (HDL). The study power was 99% for total cholesterol, 46% for triglycerides and 93% for HDL. Timolol-hydrochlorothiazide had no significant effect, suggesting that the use of such drugs to offset the adverse effects of antihypertensive drugs on lipoproteins is not effective; the selection of alternative antihypertensive agents appears to be a preferable strategy.
D000420:Albuterol / Q000008:administration & dosage* / Q000627:therapeutic use; D000584:Amiloride / Q000008:administration & dosage* / Q000627:therapeutic use; D002986:Clinical Trials as Topic; D004359:Drug Therapy, Combination; D006801:Humans; D006852:Hydrochlorothiazide / Q000009:adverse effects* / Q000627:therapeutic use; D006973:Hypertension / Q000188:drug therapy*; D008074:Lipoproteins / Q000097:blood*; D013999:Timolol / Q000009:adverse effects* / Q000627:therapeutic use
D008074:Lipoproteins; D006852:Hydrochlorothiazide; D000584:Amiloride; D013999:Timolol; D000420:Albuterol