Comparative effects of doxazosin and hydrochlorothiazide on serum lipids and blood pressure in essential hypertension

• Published in: The American journal of cardiology Vol. 59; no. 14; pp. G99 - G104
• Main Authors: Trost, Bernhard N., Weidmann, Peter, Riesen, Walter, Claessens, Jean, Streulens, Yves, Nelemans, Frans
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 29.05.1987
• Subjects: Adrenergic alpha-Antagonists - adverse effects; Adrenergic alpha-Antagonists - therapeutic use; Adult; Aged; Antihypertensive Agents - adverse effects; Antihypertensive Agents - therapeutic use; Blood Pressure - drug effects; Clinical Trials as Topic; Double-Blind Method; Doxazosin; Female; Heart Rate - drug effects; Humans; Hydrochlorothiazide - adverse effects; Hydrochlorothiazide - therapeutic use; Hypertension - blood; Hypertension - drug therapy; Lipids - blood; Male; Middle Aged; Prazosin - adverse effects; Prazosin - analogs & derivatives; Prazosin - therapeutic use; Prospective Studies; Random Allocation
• ISSN: 0002-9149; 1879-1913
• DOI: 10.1016/0002-9149(87)90167-6

The efficacy and safety of doxazosin (mean dosage 6.9 mg, range 1 to 16) in the treatment of essential hypertension were compared in a double-blind study with those of hydrochlorothiazide (HCTZ) (mean dosage, 84.6 mg, range 25 to 100) in 104 hypertensive patients treated once daily for 6 months. Thirty-five patients were also assessed for comparative effects of the 2 agents on serum lipid parameters. Doxazosin produced potentially favorable changes from baseline in the concentrations of serum lipid fractions (total triglycerides, total cholesterol, high density lipoprotein [HDL] cholesterol and the derived HDL/total cholesterol ratio) compared with HCTZ. The decreases in total triglyceride and total cholesterol concentrations and an increase in the HDL/total cholesterol ratio were significantly different (p < 0.006) from the opposite changes observed with HCTZ. Clinically relevant decreases from baseline in supine and standing blood pressures at 24 hours after administration did not significantly differ between the 2 agents. The incidence and severity of side effects were similar for both drugs. Three patients receiving doxazosin and 6 receiving HCTZ were withdrawn due to drug-related clinical side effects including 2 patients receiving HCTZ who were withdrawn because of laboratory test abnormalities. Eight HCTZ- and 1 doxazosin-treated patients developed hypokalemia and 6 HCTZ-treated patients developed hyperuricemia. These findings indicate that doxazosin and HCTZ provide comparable antihypertensive efficacy after 6 months of treatment using a once-daily regimen, but doxazosin produces a beneficial effect on the serum lipid profile as well as fewer biochemical aberrations.