Clozapine and hypertension: a chart review of 82 patients.
OBJECTIVE
Clozapine has been linked to significant weight gain and increase in serum lipids and appears to negatively impact glucose metabolism. In this retrospective chart review study, we examine changes in systolic and diastolic blood pressure and treatment for hypertension in clozapine-treated patients.


METHODS
Data on demographics and systolic and diastolic blood pressure were examined for up to 5 years (September 1987 to September 1992) in 82 patients treated with clozapine. Rates of hypertension treatment in clozapine-treated patients were compared with patients receiving conventional antipsychotics (N = 56) and other atypical antipsychotic agents (N = 102).


RESULTS
The mean age of the 82 patients at the time of clozapine initiation was 36.4 +/- 7.8 years, with 22 (27%) female, 75 (91%) white, 3 (4%) black, 3 (4%) Hispanic, and 1 (1%) Asian. The baseline weight was 175.5 +/- 34.0 lb (79.0 +/- 15.3 kg) and baseline body mass index was 26.9 +/- 5.0 kg/m(2). There was a significant increase in systolic blood pressure (p =.0004) and diastolic blood pressure (p =.0001). Overall, 22 patients (27%) received treatment for hypertension following clozapine initiation. Only 2 (4%) of 56 patients in the conventional antipsychotic group and 9 (9%) of 102 patients in the other atypical antipsychotic group (olanzapine, N = 6; risperidone, N = 3) received treatment for hypertension.


CONCLUSIONS
Our findings suggest that long-term clozapine treatment is associated with increased rates of hypertension, which may have a significant impact on medical morbidity and mortality.
Henderson
David C
DC
Department of Psychiatry, Harvard Medical School and the MGH Biostatistics Program, Massachusetts General Hospital, Boston, Massachusetts, USA. dchenderson@partners.org
Daley
Tara B
TB
Kunkel
Laura
L
Rodrigues-Scott
Myisha
M
Koul
Pamposh
P
Hayden
Doug
D
D000328:Adult; D000959:Antihypertensive Agents / Q000627:therapeutic use; D014150:Antipsychotic Agents / Q000009:adverse effects* / Q000494:pharmacology / Q000627:therapeutic use; D001794:Blood Pressure / Q000187:drug effects; D015992:Body Mass Index; D001835:Body Weight / Q000187:drug effects; D003024:Clozapine / Q000009:adverse effects* / Q000494:pharmacology / Q000627:therapeutic use; D003971:Diastole / Q000187:drug effects; D005260:Female; D006801:Humans; D006973:Hypertension / Q000139:chemically induced* / Q000188:drug therapy / Q000453:epidemiology; D008297:Male; D008499:Medical Records / Q000706:statistics & numerical data; D011618:Psychotic Disorders / Q000188:drug therapy; D012189:Retrospective Studies; D012559:Schizophrenia / Q000188:drug therapy*; D013599:Systole / Q000187:drug effects
D000959:Antihypertensive Agents; D014150:Antipsychotic Agents; D003024:Clozapine