Diuretics and β-blockers: Is there a risk for dyslipidemia?

Background Hypertension is a major risk factor for cardiovascular disease, particularly in combination with other risk factors such as obesity, smoking, diabetes, and dyslipidemia. Effective management of hypertension, even a modest reduction in blood pressure, results in reduced mortality and morbidity from cerebrovascular and cardiovascular disease. Methods Data from clinical trials were examined to assess the effect of low-dose diuretics or β-blockers on lipoprotein profile. Results Results of numerous clinical trials demonstrate that low doses of thiazides or cardioselective β-blockers alone or in combination result in minimal changes in lipid profile. Conclusions Low doses of thiazide diuretics or β-blockers are a safe and effective approach to the management of uncomplicated essential hypertension and have the advantage of an association with an evidence-based reduction in morbidity and mortality in long-term clinical trials. There is little or no evidence that the minimal changes in serum lipid profile associated with use of these drugs have resulted in a negation of the beneficial effects of these agents on blood pressure. (Am Heart J 2000;139:174-84.)