Abstract
Background Thiazides and Β-blockers cause adverse metabolic effects (AMEs), but whether these effects share predictors with blood pressure (BP) response is unknown. We aimed to determine whether AMEs are correlated with BP response in uncomplicated hypertensives. Methods In a multicenter, open-label, parallel-group trial, we enrolled 569 persons, aged 17-65, with random assignment to 9 weeks of daily hydrochlorothiazide (HCTZ) or atenolol monotherapy, followed by 9 weeks of add-on therapy with the alternate agent. Measurements included home BP, averaged over 1 week, weight and fasting levels of serum glucose, low-density lipoprotein (LDL), high-density lipoprotein (HDL), triglycerides, and uric acid (UA) before and after monotherapy and after add-on therapy. Results Increases in UA correlated with reductions in systolic BP (SBP) (r = 0.18; P = 0.003) and diastolic BP (DBP) (r = 0.20; P = 0.001) following HCTZ monotherapy and add-on therapy (r = 0.27 and r = 0.21, respectively; both P< 0.001). After adjustment for age, race, gender, and baseline body mass index (BMI), only the correlation between UA and DBP response became nonsignificant. Reductions in HDL correlated with systolic response following atenolol monotherapy (r = 0.18; P = 0.002) and with systolic and diastolic response following add-on therapy (r = 0.30 and r = 0.24, respectively; both P< 0.0001). These correlations remained significant after covariate adjustment. BP responses were not correlated with changes in glucose, LDL, triglycerides, or weight following either therapy. Conclusions BP response correlated with changes in UA following HCTZ therapy and HDL following atenolol therapy. No other significant correlations were observed between BP response and AMEs, suggesting that these effects generally do not share predictors. Patients should be monitored for AMEs, regardless of BP response.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 359-365 |
| Number of pages | 7 |
| Journal | American Journal of Hypertension |
| Volume | 25 |
| Issue number | 3 |
| DOIs | |
| State | Published - Mar 2012 |
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Keywords
- β-blockers
- atenolol
- blood pressure
- hydrochlorothiazide
- hypertension
- metabolic effects
- thiazide diuretics
ASJC Scopus subject areas
- Internal Medicine
Cite this
Blood pressure responses and metabolic effects of hydrochlorothiazide and atenolol. / Smith, Steven M.; Gong, Yan; Turner, Stephen T; Cooper-Dehoff, Rhonda M.; Beitelshees, Amber L.; Chapman, Arlene B.; Boerwinkle, Eric; Bailey, Kent R; Johnson, Julie A.; Gums, John G.
In: American Journal of Hypertension, Vol. 25, No. 3, 03.2012, p. 359-365.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Blood pressure responses and metabolic effects of hydrochlorothiazide and atenolol
AU - Smith, Steven M.
AU - Gong, Yan
AU - Turner, Stephen T
AU - Cooper-Dehoff, Rhonda M.
AU - Beitelshees, Amber L.
AU - Chapman, Arlene B.
AU - Boerwinkle, Eric
AU - Bailey, Kent R
AU - Johnson, Julie A.
AU - Gums, John G.
PY - 2012/3
Y1 - 2012/3
N2 - Background Thiazides and Β-blockers cause adverse metabolic effects (AMEs), but whether these effects share predictors with blood pressure (BP) response is unknown. We aimed to determine whether AMEs are correlated with BP response in uncomplicated hypertensives. Methods In a multicenter, open-label, parallel-group trial, we enrolled 569 persons, aged 17-65, with random assignment to 9 weeks of daily hydrochlorothiazide (HCTZ) or atenolol monotherapy, followed by 9 weeks of add-on therapy with the alternate agent. Measurements included home BP, averaged over 1 week, weight and fasting levels of serum glucose, low-density lipoprotein (LDL), high-density lipoprotein (HDL), triglycerides, and uric acid (UA) before and after monotherapy and after add-on therapy. Results Increases in UA correlated with reductions in systolic BP (SBP) (r = 0.18; P = 0.003) and diastolic BP (DBP) (r = 0.20; P = 0.001) following HCTZ monotherapy and add-on therapy (r = 0.27 and r = 0.21, respectively; both P< 0.001). After adjustment for age, race, gender, and baseline body mass index (BMI), only the correlation between UA and DBP response became nonsignificant. Reductions in HDL correlated with systolic response following atenolol monotherapy (r = 0.18; P = 0.002) and with systolic and diastolic response following add-on therapy (r = 0.30 and r = 0.24, respectively; both P< 0.0001). These correlations remained significant after covariate adjustment. BP responses were not correlated with changes in glucose, LDL, triglycerides, or weight following either therapy. Conclusions BP response correlated with changes in UA following HCTZ therapy and HDL following atenolol therapy. No other significant correlations were observed between BP response and AMEs, suggesting that these effects generally do not share predictors. Patients should be monitored for AMEs, regardless of BP response.
AB - Background Thiazides and Β-blockers cause adverse metabolic effects (AMEs), but whether these effects share predictors with blood pressure (BP) response is unknown. We aimed to determine whether AMEs are correlated with BP response in uncomplicated hypertensives. Methods In a multicenter, open-label, parallel-group trial, we enrolled 569 persons, aged 17-65, with random assignment to 9 weeks of daily hydrochlorothiazide (HCTZ) or atenolol monotherapy, followed by 9 weeks of add-on therapy with the alternate agent. Measurements included home BP, averaged over 1 week, weight and fasting levels of serum glucose, low-density lipoprotein (LDL), high-density lipoprotein (HDL), triglycerides, and uric acid (UA) before and after monotherapy and after add-on therapy. Results Increases in UA correlated with reductions in systolic BP (SBP) (r = 0.18; P = 0.003) and diastolic BP (DBP) (r = 0.20; P = 0.001) following HCTZ monotherapy and add-on therapy (r = 0.27 and r = 0.21, respectively; both P< 0.001). After adjustment for age, race, gender, and baseline body mass index (BMI), only the correlation between UA and DBP response became nonsignificant. Reductions in HDL correlated with systolic response following atenolol monotherapy (r = 0.18; P = 0.002) and with systolic and diastolic response following add-on therapy (r = 0.30 and r = 0.24, respectively; both P< 0.0001). These correlations remained significant after covariate adjustment. BP responses were not correlated with changes in glucose, LDL, triglycerides, or weight following either therapy. Conclusions BP response correlated with changes in UA following HCTZ therapy and HDL following atenolol therapy. No other significant correlations were observed between BP response and AMEs, suggesting that these effects generally do not share predictors. Patients should be monitored for AMEs, regardless of BP response.
KW - β-blockers
KW - atenolol
KW - blood pressure
KW - hydrochlorothiazide
KW - hypertension
KW - metabolic effects
KW - thiazide diuretics
UR - http://www.scopus.com/inward/record.url?scp=84857039982&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84857039982&partnerID=8YFLogxK
U2 - 10.1038/ajh.2011.215
DO - 10.1038/ajh.2011.215
M3 - Article
VL - 25
SP - 359
EP - 365
JO - American Journal of Hypertension
JF - American Journal of Hypertension
SN - 0895-7061
IS - 3
ER -