NDLI: Changes in selected metabolic parameters in patients over 65 receiving hydrochlorothiazide plus amiloride, atenolol or placebo in the MRC elderly trial

Content Provider	Springer Nature : BioMed Central
Author	Damian, Damian J. McNamee, Roseanne Carr, Matthew
Abstract	Background Treatment of hypertension reduces incidence of stroke, myocardial infarction and heart failure perhaps partly by controlling different metabolic parameters. There is limited information regarding the changes in potassium, sodium, weight, cholesterol and glucose levels in patients using anti-hypertensives. This study aimed to determine changes in potassium, sodium, glucose, cholesterol, weight, urea and urate levels in patients using anti-hypertensives. Furthermore, to describe these changes and differences between the atenolol, hydrochlorothiazide plus amiloride and placebo arms of the Medical Research Council (MRC) elderly randomised controlled trial. Methods Patients were randomly allocated to one of the three treatment arms. Measurements were taken at baseline, end of year one and end of year two in 4396 subjects. Linear Mixed Models (LMM) were used to determine the longitudinal profiles of sodium, potassium, weight, cholesterol, glucose, urea and urate. Estimates of changes within groups and difference between groups were obtained. Results Patients randomised to receive hydrochlorothiazide + amiloride experienced a significantly greater mean reduction in potassium, sodium and weight compared to placebo at end of year one - mean differences in change −0.18 mmol/L, (95 % CI: −0.21, −0.15); −1.45 mmol/L, (95 % CI: −1.62, −1.29) and −0.46 kgs (95 % CI: −0.73, −0.20) respectively, and greater increases in cholesterol, urea and urate - mean differences in change 0.16 mmol/L, (95 % CI: 0.10,0.22); 0.77 mmol/L, (95 % CI: 0.68, 0.87) and 53.10 μmol/L, (95 % CI: 49.35, 56.85) respectively. Changes were in the same direction but smaller in the atenololarm except for potassium and weight (increases). No group differences in glucose were found. Conclusion Results were in line with expectation except for lack of change in glucose in the hydrochlorothiazide + amiloride arms.
Related Links	https://bmccardiovascdisord.biomedcentral.com/counter/pdf/10.1186/s12872-016-0368-2.pdf
Ending Page	9
Page Count	9
Starting Page	1
File Format	HTM / HTML
ISSN	14712261
DOI	10.1186/s12872-016-0368-2
Journal	BMC Cardiovascular Disorders
Issue Number	1
Volume Number	16
Language	English
Publisher	BioMed Central
Publisher Date	2016-10-04
Access Restriction	Open
Subject Keyword	Cardiology Cardiac Surgery Angiology Blood Transfusion Medicine Internal Medicine Medicine Public Health Anti-hypertensive Hydrochlorothiazide Amiloride Atenolol Metabolic parameters MRC Medicine/Public Health
Content Type	Text
Resource Type	Article
Subject	Cardiology and Cardiovascular Medicine
Journal Impact Factor	2/2023
5-Year Journal Impact Factor	2.3/2023

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