A comparison of the effects of hydrochlorothiazide and captopril on glucose and lipid metabolism in patients with hypertension

Article Abstract:

Hypertension blood pressure can be controlled with different types of antihypertensive drugs to lower blood pressure. Hydrochlorothiazide is a drug that eliminates fluid from the body (a diuretic), while captopril works by blocking the action of angiotensin, a substance secreted by the body which constricts blood vessels to raise blood pressure. Antihypertensive drugs have been effective in lowering the incidence of stroke, congestive heart failure, and kidney failure, all of which are associated with hypertension. These drugs are not effective, however, in reducing the rate of heart attacks. These drugs are known to affect sugar and fat metabolism, causing diabetes and high levels of fat in the blood, which contributes to the development of atherosclerosis, the hardening of blood vessels supplying the heart muscle. These narrowed or blocked blood vessels can also cause heart muscle death and heart attacks (myocardial infarctions). To determine the effect hydrochlorothiazide and captopril have on sugar, fat, and insulin metabolism, 50 patients with hypertension were evaluated over two four-month periods. It was found that hydrochlorothiazide treatment had unfavorably increased the blood concentrations of low density lipoprotein (LDL) cholesterol and triglycerides as well as increasing insulin concentrations. Captopril did not affect sugar or fat metabolism. It is suggested that these changes due to hydrochlorothiazide may contribute to the development of diabetes and coronary heart disease. The authors point out, however, that the results of this study do not prove such a conclusion.

Complications and side effects, Development and progression, Coronary heart disease, Antihypertensive drugs, Antihypertensive agents, Hydrochlorothiazide

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Quality of life and antihypertensive therapy in men: a comparison of captopril with enalapril

Article Abstract:

Captopril and enalapril appear to be equally effective and safe in treating high blood pressure but have substantially different effects on patients' quality of life. Captopril and enalapril belong to the same pharmacologic class of drugs known as angiotensin-converting-enzyme (ACE) inhibitors. Of 379 men with mild to moderate high blood pressure, 192 took captopril and 187 took enalapril. After 24 weeks of treatment, there were no significant differences in blood pressure or the occurrence of side effects between the two groups. However, patients who took captopril reported significant improvements in their perception of their general health, psychological well-being and vitality. Patients who took enalapril reported declines in their well-being at work or in their daily routine, perception of their general health and vitality. In both groups, patients who experienced the greatest improvements in their quality of life had the lowest quality of life scores before treatment was initiated.

Evaluation, ACE inhibitors, Angiotensin converting enzyme inhibitors, Quality of life, Enalapril

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Hypertension and associated metabolic abnormalities - the role of insulin resistance and the sympathoadrenal system

Article Abstract:

Abnormal metabolism of glucose, lipoproteins, and insulin may lead to hypertension by causing changes in the sympathetic nervous system and the adrenal glands, which increase heart rate and blood pressure. High blood levels of insulin are common in hypertensive and obese people, may increase the risk of coronary heart disease, and tend to stimulate the sympathetic nervous system. Such elevated insulin levels may also decrease adrenal gland output, which decreases levels of high density lipoprotein, contributing to coronary heart disease. Hypertensive people with metabolic abnormalities should have their hypertension treated with diet and physical activity. If these people receive drug therapy, they should be given the antihypertensive drugs that improve insulin activity and the risk of coronary heart disease, rather than the drugs that indirectly raise blood levels of insulin.

Insulin resistance

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