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Lipid Effects of Antihypertensive Medications

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Abstract

Thiazide diuretics and beta-blockers are first-line therapies for hypertension unless there are compelling indications for other drug classes. Diuretics and beta-blockers, however, may worsen dyslipidemia and glucose tolerance whereas antihypertensive agents in other drug classes may have neutral or beneficial effects. Initial clinical trials of antihypertensive regimens suggested that blood pressure lowering was the most important aspect of therapy and that the adverse effects on lipids and glucose tolerance did not impact clinical outcomes. Newer trials, however, question this finding and implicate these pleotropic effects as contributing to the results of the trials. Patients with cardiometabolic risk factors may have compelling indications for agents that inhibit the renin-angiotensin-aldosterone system, relegating diuretics and beta-blockers to third-line therapy.

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Disclosure

R. Deano: none; M. Sorrentino has received payment for development of educational presentations from Merck, Pfizer, and Novartis.

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  1. Department of Medicine, University of Chicago Pritzker School of Medicine, 5841 S. Maryland Ave, MC 6080, Chicago, IL, 60637, USA

    Roderick Deano

  2. Department of Medicine, Section of Cardiology, University of Chicago Pritzker School of Medicine, 5841 S. Maryland Ave, MC 6080, Chicago, IL, 60637, USA

    Matthew Sorrentino

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Correspondence to Matthew Sorrentino.

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Deano, R., Sorrentino, M. Lipid Effects of Antihypertensive Medications. Curr Atheroscler Rep 14, 70–77 (2012). https://doi.org/10.1007/s11883-011-0214-z

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