Doxazosin versus bendrofluazide: a comparison of the metabolic effects in British South Asians with hypertension.
BACKGROUND
People from British South Asian communities have an increased risk of mortality from coronary heart disease (CHD). Doxazosin, a selective alpha(1)-adrenergic blocker, in addition to lowering blood pressure, has been shown to have positive effects on glucose metabolism and lipid profiles in patients with hypertension.


OBJECTIVE
We studied doxazosin (1-8 mg) and bendrofluazide (2.5 mg) in patients of British South Asian origin with existing mild to moderate hypertension (doxazosin n = 78; bendrofluazide n = 82), to compare their effects on glucose and lipid metabolism in this group.


METHODS
A 34-week randomised, double-blind, parallel-group, multicentre study.


METHODS
Primary care in the UK.


METHODS
All doxazosin patients started with an initial dose of 1 mg once daily, titrated to a maximum 8 mg once daily if diastolic blood pressure was >90 mmHg or was not <5 mmHg of the baseline value. The primary efficacy variables were mean glucose and total cholesterol concentrations at week 21.


RESULTS
Doxazosin reduced glucose, total cholesterol, low-density lipoprotein-cholesterol and triglycerides and increased high-density lipoprotein-cholesterol. There were significant differences between doxazosin and bendrofluazide for glucose concentrations at week 21 (P = 0.029) and week 34 (P = 0.015), total cholesterol at week 21 (P = 0.048) and triglycerides at week 21 (P = 0.047) and week 34 (P = 0.009). There was no significant difference in blood pressure lowering between the two treatments.


CONCLUSIONS
Doxazosin exhibits beneficial effects on glucose concentrations and lipid profile, in particular in lowering triglyceride concentrations in British South Asians. Whether these desirable characteristics translate to improved overall cardiovascular risk requires formal evaluation.
Hobbs
Fd Richard
FR
Department of Primary Care and General Practice, University of Birmingham, Birmingham. f.d.r.hobbs@bham.ac.uk
Khan
Tahir
T
Collins
Barbara
B
D000293:Adolescent; D000317:Adrenergic alpha-Antagonists / Q000378:metabolism* / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000959:Antihypertensive Agents / Q000378:metabolism* / Q000627:therapeutic use; D001210:Asia, Southeastern / Q000208:ethnology; D001539:Bendroflumethiazide / Q000378:metabolism* / Q000627:therapeutic use; D001786:Blood Glucose / Q000378:metabolism; D002784:Cholesterol / Q000378:metabolism; D004311:Double-Blind Method; D017292:Doxazosin / Q000378:metabolism* / Q000627:therapeutic use; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000208:ethnology / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome; D006113:United Kingdom / Q000453:epidemiology
D000317:Adrenergic alpha-Antagonists; D000959:Antihypertensive Agents; D001786:Blood Glucose; D001539:Bendroflumethiazide; D002784:Cholesterol; D017292:Doxazosin