Metabolic changes during antihypertensive therapies.

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Krone W, Nagele H

Metabolic changes during antihypertensive therapies.

J Hum Hypertens. 1989 Dec;3 Suppl 2:69-73; discussion 74.

PubMed ID

2575177 [ View in PubMed

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Abstract

There is controversy whether various classes of antihypertensive drugs can reduce significantly cardiovascular morbidity and mortality in primary prevention. A failure to show this in many studies was attributed, at least in part, to deleterious effects of these drugs on lipid metabolism. Especially adrenergic antihypertensives cause marked effects on lipoprotein levels in plasma. A review of the literature revealed that beta-blockers increase triglycerides and VLDL (very low density lipoprotein)-cholesterol and may lower plasma HDL (high density lipoprotein) levels. In contrast alpha 1-adrenergic inhibitors like prazosin, doxazosin and terazosin lower triglycerides, total cholesterol, LDL (low density lipoprotein)- and VLDL-cholesterol and increase plasma HDL levels. The mechanisms by which alpha- and beta-blockers may produce the observed effects on plasma lipids and lipoproteins are not well understood. It has been shown in our laboratory that the activity of the LDL receptor of peripheral cells, a major determinant of cholesterol levels in plasma, is regulated by catecholamines via alpha 2- and beta 2-adrenergic receptors. Accordingly, blockade of these adrenoceptors with alpha- and beta-adrenergic antagonists can reverse the catecholamine effect. In addition these agents may affect lipoprotein lipase, lecithin cholesteryl acyltransferase and cholesterol ester hydrolase. These data may explain, at least in part, the plasma effects. However, long-term studies are needed to clarify the clinical value of antihypertensives with different metabolic profiles.

DrugBank Data that Cites this Article

Pharmaco-metabolomics

Drug	Drug Groups	Metabolite	Change	Description
Terazosin	Approved	Total cholesterol	decreased	Terazosin decreases the level of Total cholesterol in the blood
Doxazosin	Approved	VLDL cholesterol	decreased	Doxazosin decreases the level of VLDL cholesterol in the blood
Doxazosin	Approved	LDL cholesterol	decreased	Doxazosin decreases the level of LDL cholesterol in the blood
Terazosin	Approved	LDL cholesterol	decreased	Terazosin decreases the level of LDL cholesterol in the blood
Terazosin	Approved	HDL cholesterol	increased	Terazosin increases the level of HDL cholesterol in the blood
Terazosin	Approved	Triglycerides	decreased	Terazosin decreases the level of Triglycerides in the blood
Terazosin	Approved	VLDL cholesterol	decreased	Terazosin decreases the level of VLDL cholesterol in the blood
Doxazosin	Approved	Triglycerides	decreased	Doxazosin decreases the level of Triglycerides in the blood