Prazosin improves atherogenic index and inhibits the deleterious effect of dihydrochlorothiazide in patients with essential hypertension.J Cardiovasc Pharmacol. 1987; 10 Suppl 12:S240-3.JC
Twenty-three patients with essential hypertension were treated consecutively with prazosin or dihydrochlorothiazide or the combination of the two, each treatment period lasting for three months. Blood pressure, heart rate (HR), serum levels of total cholesterol, triglycerides, HDL-c and LDL-c, uric acid, glucose, Na, and K were measured during the baseline and at the end of each treatment period. Both prazosin and dihydrochlorothiazide (THI) decreased blood pressure but the effect of the combination was more pronounced than that of the monotherapies. Prazosin had no effect on the plasma level of total cholesterol, triglycerides, uric acid, Na, K, and glucose but increased HDL-c, decreased LDL-c, and thereby significantly improved (decreased) atherogenic index (total cholesterol/HDL-c). THI increased total cholesterol, triglycerides, LDL + VLDL-c, glucose, and uric acid; decreased HDL-c and K levels; and significantly increased the atherogenic index. Prazosin neutralized the effects of THI on total cholesterol, triglycerides, HDL-c, and on LDL + VLDL-c but not on glucose, uric acid, or K. These results suggest that the effects of THI on plasma lipids may be mediated by alpha 1-adrenoceptor-related mechanisms but the effects on glucose, uric acid, and K, probably may not be mediated by these mechanisms.