The association between antihypertensive drug therapies and plasma lipid levels in the general population.
OBJECTIVE
To assess the association between different antihypertensive drug regimens and plasma lipid levels in the general population.


METHODS
The Monitoring Project on Cardiovascular Risk Factors was conducted from 1987 to 1991 as a cross-sectional study in The Netherlands. Antihypertensive drug-users and untreated hypertensives were selected. After exclusion of users of cholesterol-lowering drugs 2997 subjects remained for the analysis. The plasma lipid concentrations of the users and non-users of antihypertensives were compared by multiple linear regression.


RESULTS
In the univariate analysis patients using beta-blockers had lower high-density lipoprotein (HDL) concentrations (1.13 mmol/l, P < 0.05) and higher cholesterol ratios (5.74, P < 0.05) than untreated hypertensives (Total cholesterol = 6.07 mmol/l, HDL = 1.20 mmol/l and ratio = 5.44). Patients using diuretics had higher total cholesterol levels (6.34 mmol/l) and higher HDL levels (1.26 mmol/l) compared to untreated hypertensives. After adjustment for possible confounders these differences were smaller and no longer statistically significant. After adjustment we found a significant lower HDL cholesterol (mean difference of -0.10 mmol/l, P < 0.05) for users of a combination of a beta-blocker and a diuretic.


CONCLUSIONS
Although randomised, controlled trials have demonstrated that antihypertensive drugs may influence plasma lipid levels we observed no substantial association for single antihypertensive drug therapy in the general population. The combination of a diuretic and a beta-blocker was associated with a worse lipid profile.
Maitland-van der Zee
A H
AH
Utrecht Institute for Pharmaceutical Sciences (UIPS), Department of Pharmacoepidemiology and Pharmacotherapy, Utrecht University, Utrecht, The Netherlands.
Klungel
O H
OH
Kloosterman
J M
JM
Seidell
J C
JC
Leufkens
H G
HG
de Boer
A
A
D000319:Adrenergic beta-Antagonists / Q000097:blood / Q000494:pharmacology; D000328:Adult; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000097:blood / Q000494:pharmacology; D000959:Antihypertensive Agents / Q000097:blood* / Q000494:pharmacology*; D002121:Calcium Channel Blockers / Q000097:blood / Q000494:pharmacology; D002784:Cholesterol / Q000097:blood; D003430:Cross-Sectional Studies; D004232:Diuretics / Q000097:blood / Q000494:pharmacology; D005260:Female; D006801:Humans; D006973:Hypertension / Q000097:blood*; D016014:Linear Models; D008075:Lipoproteins, HDL / Q000097:blood* / Q000187:drug effects*; D008297:Male; D008875:Middle Aged
D000319:Adrenergic beta-Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D000959:Antihypertensive Agents; D002121:Calcium Channel Blockers; D004232:Diuretics; D008075:Lipoproteins, HDL; D002784:Cholesterol