A Comparison of the Effects of Amlodipine and Hydrochlorothiazide Monotherapy on Lipid Metabolism in Hypertensive Nigerians with Type 2 Diabetes Mellitus

Background: Although the association between antihypertensive therapy and lipid profiles is well established, there are very limited reports regarding the same in hypertensive Nigerians with type 2 diabetes mellitus. The aim of this study is to evaluate the extent to which treatment with amlodipine or hydrochlorothiazide would affect lipid profiles. Materials and methods: Forty newly diagnosed hypertensive subjects with controlled type 2 diabetes mellitus aged 43-68 years were randomized to amlodipine and hydrochlorothiazide treatment groups. Each group comprised 20 patients (20 males and 20 females) and they were treated, respectively, with amlodipine 10 mg and hydrochlorothiazide 25 mg, all given once daily for 48 weeks. Body mass index, blood pressure and lipid parameters were evaluated at baseline (week 0) before treatment as well as at the end of 1, 3, 6, 12, 24, 36 and 48 weeks. Results: The 2 medications significantly reduced blood pressure values, though the blood pressure-lowering effect of amlodipine was significantly greater compared with that of hydrochlorothiazide (P<0.01). Total cholesterol and triglyceride mean values were not significantly affected by drug treatment. Whereas amlodipine significantly increased high density lipoprotein cholesterol (P<0.0001) and significantly decreased low density lipoprotein cholesterol in males (P<0.001), hydrochlorothiazide did not cause any significant change in the variables. Discussion: We observed that although both drugs significantly decreased blood pressure, hydrochlorothiazide may adversely affect serum lipid profile as compared with amlodipine that exerts a beneficial effect on it. Clinicians need to consider this in the choice of drug treatment.