Effects of antihypertensive drugs on atherogenic factors: possible importance of drug selection in prevention of atherosclerosis.

The treatment of hypertension is clearly beneficial. Blood pressure reduction with antihypertensive drugs reduces mortality and the incidence of complications such as stroke, renal failure, and congestive failure. However, analysis of long-term studies using different antihypertensive drugs indicates that the outcome of patients treated in those studies may be determined by effects of the antihypertensive drugs other than the lowering of blood pressure. Evidence is increasing that certain antihypertensive drugs have adverse effects on plasma lipid profiles that are of sufficient magnitude to offset the benefit of antihypertensive treatment in mild hypertensives. Furthermore, the effects of antihypertensive drugs on arterial flow disturbances, although they have received scant attention until now, may be important in the progression of atherosclerosis or even in the primary prevention of atherosclerosis. This article highlights differences in the effects of antihypertensive drugs on plasma lipids and on arterial flow disturbances as they may pertain to prevention of atherosclerosis.