Effects of prazosin and propranolol on blood pressure and plasma lipids in patients undergoing chronic hemodialysis.

Twenty patients receiving hemodialysis who had mild to moderate hypertension were treated with prazosin or propranolol to control predialysis hypertension. Effective blood pressure control was achieved with prazosin (mean dose 8.3 +/- 2.2 mg [+/- standard error of the mean], n = 10) and propranolol (mean dose 123 +/- 39 mg, n = 10). Therapy with prazosin did not significantly affect total plasma triglyceride or total cholesterol levels. The level of high-density lipoprotein (HDL) cholesterol tended to increase, but not significantly. However, the HDL3 subfraction did increase significantly, from 16.3 +/- 1.5 to 20.6 +/- 1.5 mg/dl (p = 0.05). Propranolol therapy increased plasma triglyceride levels, primarily of the very low density lipoprotein class. HDL cholesterol levels decreased from 44.2 +/- 6.7 to 34.7 +/- 4.2 mg/dl (p less than 0.03). The reduction in the HDL cholesterol levels was attributable to a decrease in HDL2 cholesterol levels (from 21.3 +/- 3.8 to 16.3 +/-3.0 mg/dl, p less than 0.04) and HDL3 cholesterol levels (from 23.0 +/- 3.1 to 19.5 +/- 2.1 mg/dl, difference not significant). Thus, both prazosin and propranolol are effective in controlling hypertension in patients undergoing hemodialysis. HDL3 cholesterol levels increased in patients treated with prazosin, but no other significant changes in the plasma lipids occurred. Patients treated with propranolol had a significant decrease in plasma HDL2 and HDL3 cholesterol levels.