INFLUENCE OF COMBINATION OF CAPTOPRIL AND HYDROCHLOROTHIAZIDE ON PLASMA-LIPIDS, LIPOPROTEINS AND APOLIPOPROTEINS IN PRIMARY HYPERTENSION

The effects of the combination of captopril and hydrochlorothiazide at modest doses on plasma lipids, lipoproteins and apolipoproteins were investigated in 139 patients with mild to moderate primary hypertensio n. Following an eight week wash-out period and a 4 week period of mono therapy with either captopril or hydrochlorothiazide, the combination of captopril 50 mg and hydrochlorothiazide 25 mg daily was given for 1 6 weeks. All factors known to affect plasma lipids were held constant throughout the study (i.e. diet, weight, exercise, caffeine, tobacco). There were significant reductions in total and low density lipoprotei n-cholesterol (P < 0.01), total cholesterol/high density lipoprotein-c holesterol (P < 0.001) and low density lipoprotein/high density lipopr otein-cholesterol (P < 0.01) ratios. These favourable changes were sig nificant only in patients whose baseline values were above the 90th ce ntile adjusted for age and sex. The combination had a neutral effect o n plasma lipids in patients with normal values. The data suggest that the combination of captopril and hydrochlorothiazide at modest doses d oes not induce deleterious changes in lipid profile and warrant furthe r long-term controlled studies. This antihypertensive regimen may thus represent an advantageous alternative in subjects with a potentially atherogenic lipoprotein profile.