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Effects of Thiazide Diuretics on Plasma Lipids and Lipoproteins in Mildly Hypertensive Patients: A Double-Blind Controlled Trial

RICHARD H. GRIMM Jr., M.D., M.P.H.; ARTHUR S. LEON, M.D.; DONALD B. HUNNINGHAKE, M.D.; KRISTINE LENZ; PETER HANNAN; and HENRY BLACKBURN, M.D.
[+] Article and Author Information

Grant support; in part by grants from General Research Support of the School of Public Health, University of Minnesota, and from Merck Sharp & Dohme.

▸Requests for reprints should be addressed to Richard H. Grimm, Jr., M.D.; Laboratory of Physiological Hygiene, School of Public Health, University of Minnesota, Stadium Gate 27, 611 Beacon Street SE; Minneapolis, MN 55455.


Minneapolis, Minnesota


© 1981 American College of PhysiciansAmerican College of Physicians


Ann Intern Med. 1981;94(1):7-11. doi:10.7326/0003-4819-94-1-7
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A blood lipid-lipoprotein elevating effect of the diuretics hydrochlorothiazide and chlorthalidone in mildly hypertensive men has been established by a cross-over, randomized controlled trial, confirming previous clinical observations. Compared to baseline, plasma total cholesterol increased 6% and 8% and triglycerides 17% and 15% under treatment with hydrochlorothiazide and chlorthalidone, respectively. A cholesterol-lowering diet largely prevents this increase. Because these effects may be long-lasting and may cancel part of the potential benefit of blood pressure control in mildly hypertensive patients, with thiazide diuretics attention should be given to prescription of a cholesterol-lowering diet and to periodic monitoring of blood lipid levels. Different antihypertensive agents might be considered in patients with elevated blood lipid levels. Other antihypertensive agents currently in use need to be studied for potential effects on lipid metabolism.

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