Lack of Effect of Hydrocholorthiazide on Total Cholesterol

To determine the effect of hydrochlorothiazide on total cholesterol, baseline total cholesterol and blood pressure were determined in 618 hypertensive subjects in a hypertension clinic in Pusan, Korea. After 12-24 months (mean follow-up time 14 months), total cholesterol and blood pressure measurements were repeated. In the group whose therapy included hydrochlorothiazide (n = 436), total cholesterol fell by 8 +/- 39 mg/dL. Those not treated with a diuretic (n = 182) had an identical fall in total cholesterol of 8 +/- 42 mg/dL (P < 0.001 for change from baseline). Patients with a baseline total cholesterol > 200 mg/dL were asked to reduce intake of saturated fat. Change in total cholesterol for 180 patients on this diet and hydrochlorothiazide was -24 +/- 31 mg/dL (P < 0.0001); for 71 patients on the diet and non-diuretic therapy, change was -22 +/- 35 mg/dL (P < 0.0001). There was no change in total cholesterol in either drug group for those with a baseline value < or = 200 mg/dL. It is concluded that in this group of Korean patients on a relatively low-fat diet, a low dose of hydrochlorothiazide had no adverse effect on total cholesterol at 14 months, and hydrochlorothiazide nor other agents prevented a beneficial effect of further reduction of saturated fat on total cholesterol.