ADVERSE METABOLIC EFFECTS OF ANTIHYPERTENSIVE DRUGS - IMPLICATIONS FOR TREATMENT

Adverse metabolic effects have been associated with drugs used in the therapy of hypertension, especially diuretics and beta-blockers. These effects include electrolyte, glucose/insulin, lipid and uric acid dis turbances, This may explain, at least in part, why early trials examin ing the impact of antihypertensive pharmacotherapy with diuretics and beta-blockers showed beneficial effects on coronary artery disease tha t fell disappointingly short of the predicted effect, Among therapeuti c drugs, diuretics cause disturbances in electrolyte homeostasis, e.g. hypokalaemia, hypomagnesaemia, and hyponatraemia, In contrast, ACE in hibitors cause hyperkalaemia under certain circumstances, Both diureti cs and beta-blockers, especially nonselective beta-blockers that lack intrinsic sympathomimetic capabilities, have been associated with dist urbances in glucose/insulin metabolism and can cause deleterious alter ations in the profile of circulating plasma lipids, Hyperuricaemia, as sociated with diuretic use, appears to be a problem only in those pati ents who are predisposed to high circulating levels of uric acid.