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Serum Lipoprotein Levels During Chlorthalidone Therapy: Title and subTitle BreakA Veterans Administration-National Heart, Lung, and Blood Institute Cooperative Study on Antihypertensive Therapy: Mild Hypertension FREE

Anne I. Goldman, PhD; Bernard W. Steele, MD; Harold W. Schnaper, MD; Annette E. Fitz, MD; Edward D. Frohlich, MD; H. Mitchell Perry, Jr, MD
[+] Author Affiliations

For a complete list of participants in this study, see p 1695.

Reprint requests to Box 197, Division of Biometry, 1226 Mayo, University of Minnesota, Minneapolis, MN 55455 (Dr Goldman).


JAMA. 1980;244(15):1691-1695. doi:10.1001/jama.1980.03310150027023
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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.

(JAMA 244:1691-1695, 1980)

REFERENCES

Kannel WB, Dawber TR, Kagan A, et al:  Factors of risk in the development coronary heart disease—six-year followup experience: The Framingham study . Ann Intern Med 55:33-50, 1961;.
Kannel WB, Castelli WP, Gorton T, et al:  Serum cholesterol lipoproteins and risk of coronary heart disease: The Framingham study . Ann Intern Med 74:1-12, 1971;.
Gordon T, Castelli WP, Hjortland MC, et al:  High density lipoprotein as a protective factor against coronary heart disease: The Framingham study . Am J Med 62:707-714, 1977;.
Perry HM Jr, Schnaper HW, Goldman A, et al:  Evaluation of drug treatment in mild hypertension . Ann NY Acad Sci 304:267-293, 1978;.
Manual of Laboratory Operations, Lipid Research Clinics Program: I. Lipoprotein Analysis , publication NIG 75628. Bethesda, Md, National Heart and Lung Institute, 1974;.
Allain CC, Poon LS, Chan CDG, et al:  Enzymatic determination of total serum cholesterol . Clin Chem 20:1282-1291, 1974;.
Bucolo G, David H:  Quantitative determination of serum triglycerides in the use of enzymes . Clin Chem 19:476-482, 1973;.
Steele BW, Koehler DF, Azar MM, et al:  Enzymatic determinations of cholesterol in high-density-lipoprotein fractions prepared by a precipitation technique . Clin Chem 22:98-101, 1976;.
Friedewalt WT, Levy RI, Fredrickson DS:  Estimation of the concentration of low-density-lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge . Clin Chem 18:499-502, 1972;.
Johnson B, Bye C, Labrooy J, et al:  The relation of antihypertensive treatment to plasma lipids and other vascular risk factors in hypertensives . Clin Sci Mol Med 47:9-13, 1974;.
Ames RP, Hill P:  Increase in serum lipids during treatment of hypertension with chlorthalidone . Lancet 1:721-723, 1976;.
Helgeland A, Leren P, Enger SC, et al:  HDL-cholesterol in antihypertensive treatment: The Oslo study . Acta Med Scand 625( (suppl) ):131-134, 1979;.
Kaplan D (ed):  A new class of diuretic with uricosuric activity , in Postgraduate Medical Communications . Dallas, University of Texas Southwestern Medical School, 1979;.
Perry HM Jr, Mills EJ:  The effect of oral hydralazine on circulating human cholesterol . Am J Med Sci 243:564-572, 1962;.
 MRFIT protocol: Nutrition intervention strategies in MRFIT . J Am Diet Assoc , to be published.
McGee D:  The probability of developing certain cardiovascular disease in eight years at specified values of some characteristics , in Kannel WB, Gordon T (eds): The Framingham Study: An Epidemiological Investigation of Cardiovascular Disease , publication No. 74-618. US Dept of Health, Education, and Welfare, 1973;, section 28.

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Kannel WB, Dawber TR, Kagan A, et al:  Factors of risk in the development coronary heart disease—six-year followup experience: The Framingham study . Ann Intern Med 55:33-50, 1961;.
Kannel WB, Castelli WP, Gorton T, et al:  Serum cholesterol lipoproteins and risk of coronary heart disease: The Framingham study . Ann Intern Med 74:1-12, 1971;.
Gordon T, Castelli WP, Hjortland MC, et al:  High density lipoprotein as a protective factor against coronary heart disease: The Framingham study . Am J Med 62:707-714, 1977;.
Perry HM Jr, Schnaper HW, Goldman A, et al:  Evaluation of drug treatment in mild hypertension . Ann NY Acad Sci 304:267-293, 1978;.
Manual of Laboratory Operations, Lipid Research Clinics Program: I. Lipoprotein Analysis , publication NIG 75628. Bethesda, Md, National Heart and Lung Institute, 1974;.
Allain CC, Poon LS, Chan CDG, et al:  Enzymatic determination of total serum cholesterol . Clin Chem 20:1282-1291, 1974;.
Bucolo G, David H:  Quantitative determination of serum triglycerides in the use of enzymes . Clin Chem 19:476-482, 1973;.
Steele BW, Koehler DF, Azar MM, et al:  Enzymatic determinations of cholesterol in high-density-lipoprotein fractions prepared by a precipitation technique . Clin Chem 22:98-101, 1976;.
Friedewalt WT, Levy RI, Fredrickson DS:  Estimation of the concentration of low-density-lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge . Clin Chem 18:499-502, 1972;.
Johnson B, Bye C, Labrooy J, et al:  The relation of antihypertensive treatment to plasma lipids and other vascular risk factors in hypertensives . Clin Sci Mol Med 47:9-13, 1974;.
Ames RP, Hill P:  Increase in serum lipids during treatment of hypertension with chlorthalidone . Lancet 1:721-723, 1976;.
Helgeland A, Leren P, Enger SC, et al:  HDL-cholesterol in antihypertensive treatment: The Oslo study . Acta Med Scand 625( (suppl) ):131-134, 1979;.
Kaplan D (ed):  A new class of diuretic with uricosuric activity , in Postgraduate Medical Communications . Dallas, University of Texas Southwestern Medical School, 1979;.
Perry HM Jr, Mills EJ:  The effect of oral hydralazine on circulating human cholesterol . Am J Med Sci 243:564-572, 1962;.
 MRFIT protocol: Nutrition intervention strategies in MRFIT . J Am Diet Assoc , to be published.
McGee D:  The probability of developing certain cardiovascular disease in eight years at specified values of some characteristics , in Kannel WB, Gordon T (eds): The Framingham Study: An Epidemiological Investigation of Cardiovascular Disease , publication No. 74-618. US Dept of Health, Education, and Welfare, 1973;, section 28.
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