FLUCTUATIONS IN BLOOD LIPID-LEVELS DURING FUROSEMIDE THERAPY - A RANDOMIZED, DOUBLE-BLIND, PLACEBO-CONTROLLED CROSSOVER STUDY

Background: Acute decreases in intravascular volume are associated wit h increases in lipid levels. Furosemide causes acute changes in intrav ascular volume during prolonged therapy but is thought to have little effect on lipid levels. Methods: To determine if there are daily acute rises in lipid and lipoprotein levels associated with changes in intr avascular volume during long-term furosemide ingestion therapy, we per formed a randomized, double-blind, placebo-controlled crossover study in 10 patients. Results: In the 8 hours after furosemide ingestion the re were-increases in levels of plasma cholesterol (10.1%; P=.001), hig h-density lipoprotein cholesterol (9.0%; P=.006), and apolipoprotein B (9.8%; P=.003). The increases in levels of triglycerides (11.5%; P=.1 7) and apolipoprotein A-1 (13.3%; P=.051) were of similar magnitude bu t more variable and did not achieve statistical significance. There wa s no substantial change in the total cholesterol-high-density lipoprot ein cholesterol ratio (0.6%; 95% CI, -0.74% to 8.6%; P=.88). Conclusio n: This study indicates that there are acute increases in lipid levels after furosemide ingestion during prolonged therapy, which could affe ct the interpretation of lipid levels and cardiovascular risk in patie nts.