Mechanism of differential effects of antihypertensive agents on serum lipids

被引：44
作者：
Brook R.D. [1 ]
机构：
[1] Division of Hypertension, 3918 Taubman Center, University of Michigan, Ann Arbor, MI 48104
来源：
Current Hypertension Reports | 2000年 / 2卷 / 4期
关键词：
Insulin Sensitivity; Angiotensin Converting Enzyme Inhibitor; Antihypertensive Agent; Lipoprotein Lipase Activity; Postprandial Lipemia;
D O I：
10.1007/s11906-000-0040-0
中图分类号：
学科分类号：
摘要：
Essential hypertension is frequently associated with the metabolic abnormalities of insulin resistance and dyslipidemia. This prevalent clustering of multiple cardiovascular risk factors may help explain the less-than-expected improvement in coronary heart disease mortality provided by simple blood pressure reduction alone. Many antihypertensive medications effectively reduce blood pressure while providing no benefit or even causing a detrimental effect on the associated metabolic abnormalities. (3-Blockers and diuretics tend to negatively affect both glucose tolerance and plasma lipids. Calcium channel blockers, angiotensin converting enzyme inhibitors, and angiotensin II receptor blockers are most often found to be metabolically neutral. a-Blockers provide the most favorable metabolic effects of antihypertensive agents by improving both insulin sensitivity and dyslipidemia. The multiple physiologic mechanisms by which blood pressure medications alter plasma lipids are discussed in detail. The effects of antihypertensive medications on postprandial lipid metabolism and the associated postprandial lipemia-induced endothelial dysfunction deserve special attention. Copyright © 2000 by Current Science Inc.
引用
收藏
页码：370 / 377
页数：7
相关论文
共 50 条
  • [1] Collins R., Peto R., MacMahon S., Et al., Blood pressure, stroke, and coronary artery disease. Part 2. Short-term reduction in blood pressure: Overview of randomized drug trials in their epidemiological context, Lancet, 335, pp. 827-838, (1990)
  • [2] Julius S., Jamerson K., Sympathetics, insulin resistance and coronary risk in hypertension: The chicken and egg' question, J Hypertens, 12, pp. 495-502, (1994)
  • [3] Hansson L., Lindholm L.H., Ekbom T., Et al., Randomised trial of old and new antihypertensive drugs in elderly patients: Cardiovascular mortality and morbidity. The Swedish Trial in Old Patients with Hypertension 2 study, Lancet, 354, pp. 1751-1756, (1999)
  • [4] Hansson L., Lindholm L.H., Niskanen L., Et al., Effect of angiotensin converting enzyme inhibition compared with conven tional therapy on cardiovascular morbidity and mortality in hypertension: The Captopril Prevention Project (CAPPP) randomised trial, Lancet, 353, pp. 611-616, (1999)
  • [5] Kasiske B.L., Ma J.Z., Roberto S.N., Et al., Effects of antihypertensive therapy on serum lipids, Ann Intern Med, 122, pp. 133-141, (1995)
  • [6] Lakshman M.R., Reda D.J., Matersib B.J., Et al., Diuretics and beta blockers do not have adverse effects at 1 year on plasma lipid and lipoprotein profiles in men with hypertension, Arch Intern Med, 159, pp. 551-558, (1999)
  • [7] Savage P.J., Pressel S.L., Curb J.D., Et al., Influence of long-term, low dose, diuretic based, antihypertensive therapy on glucose, lipid, uric acid, and potassium levels in older men and women with isolated systolic hypertension: The Systolic Hypertension in the Elderly Program, Arch Intern Med, 158, pp. 741-751, (1998)
  • [8] Grimm R.H., Flack J.M., Grandits G.A., Et al., Long-term effects on plasma lipids of diet and drugs to treat hypertension, JAMA, 275, pp. 1549-1556, (1996)
  • [9] Groop L., Bodadonna R.C., DelPrato S., Et al., Effect of insulin on oxidative and non oxidative pathways of glucose and FFA metabolism in NIDDM, J Clin Invest, 84, pp. 205-213, (1989)
  • [10] Nurjhan N., Consoli A., Gerich J., Increased lipolysis and its consequences on gluconeogenesis in non insulin dependent diabetes mellitus, J Clin Invest, 89, pp. 169-175, (1992)
12345