Key result
After one year, chlorthalidone therapy increased total cholesterol by 10.0 mg/dL, triglycerides by 9.8 mg/dL, and LDL-cholesterol by 12.6 mg/dL compared to placebo.
Why the study?
Does chlorthalidone therapy alter serum lipoprotein levels in patients with mild hypertension?
RCT (n=1,012)
Double-blind
randomized
Yes
Does chlorthalidone therapy alter serum lipoprotein levels in patients with mild hypertension?
Mean Difference: 10
Long-term treatment of mild hypertension with chlorthalidone is associated with significant increases in atherogenic serum lipid levels compared to placebo.
Chlorthalidone raises atherogenic lipids in mild hypertension; confirms adverse metabolic effects that warrant lipid monitoring in long-term use.
In a joint Veterans Administration-National Heart, Lung, and Blood Institute study of mild hypertension, 1,012 men and women, 21 to 50 years of age and with diastolic pressure from 85 to 105 mm Hg, were randomized into two double-blind treatment groups. Subjects in the active group received chlorthalidone or chlorthalidone plus reserpine, while the other subjects received matching placebo tablets. After one year of treatment, the chlorthalidone group had increases of 10.0 +/- 1.8 (SE) mg/dL in total cholesterol level, 9.8 +/- 5.2 mg/dL in triglyceride level, and 12.6 +/- 3.4 mg/dL in low-density lipoprotein-cholesterol level above the changes in the placebo group. There was no difference in high-density lipoprotein changes between the two groups (0.1 +/- 0.8 mg/dL). The possible net effect on risk of increasing lipid values while lowering pressure in the long-term treatment of mild hypertension with thiazides or related diuretics must be further evaluated.
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Anne I. Goldman (1980) conducted an RCT in Mild hypertension (n=1,012). Chlorthalidone or chlorthalidone plus reserpine vs. Placebo was evaluated on Change in total cholesterol level (MD 10.0 mg/dL). After one year, chlorthalidone therapy increased total cholesterol by 10.0 mg/dL, triglycerides by 9.8 mg/dL, and LDL-cholesterol by 12.6 mg/dL compared to placebo.
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