Clinical Significance

Use of thiazide diuretics in the treatment of hypertension and chronic edematous states is a double-edged sword. Thus, at moderate to high doses, thiazides increase LDL cholesterol about 8-10%. Although several studies indicate that blood pressure does indeed reduce cardiovascular risk despite hyperlipidemia, an increase in LDL cholesterol of 10% may offset the net reduction in cardiovascular mortality derived from blood pressure lowering alone.

Like the adverse effects of thiazides on glucose metabolism, their effect on plasma lipids is reversible. Therefore, discontinuation of thiazides and use of alternative agents which either lower (e.g., ACE inhibitors, calcium channel blockers) or do not change plasma cholesterol should probably be used for treatment of hypertension in patients with preexisting hypercholesterolemia or combinations of other risk factors such as diabetes, left ventricular hypertrophy, and cigarette smoking.

Blood Pressure Health

Blood Pressure Health

Your heart pumps blood throughout your body using a network of tubing called arteries and capillaries which return the blood back to your heart via your veins. Blood pressure is the force of the blood pushing against the walls of your arteries as your heart beats.Learn more...

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