OBJECTIVE: The aim of the Antihypertensive Treatment and Lipid Profile in a North of Sweden Efficacy Evaluation study was to compare the long-term effect of the commonly used inexpensive medication with a low-dose diuretic ( @entity918 ), alone or in combination with a beta-adrenoceptor ( @entity2165 ), with that of more modern but also more expensive antihypertensive treatment with an angiotensin-II-receptor blocker ( @entity1564 ), alone or in combination with a @entity460 antagonist ( @entity10202 ), and to do so in newly diagnosed @entity1 with primary @entity101 . The objectives included comparisons of the effects on the @entity413 metabolism, lipoprotein metabolism, electrolytes, blood pressure, and subjective symptoms. DESIGN: A 1-year, prospective randomized, double-blind, controlled trial. SUBJECTS: In an investigator-initiated study, we included 392 @entity1 (mean age 55 years, 48% @entity1 ); 370 @entity1 (94%) had never been treated with antihypertensive drugs before the study. No @entity1 was lost to follow-up. RESULTS: Both treatment regimens lowered blood pressure well (23/13 mmHg in the @entity918 group and 21/13 mmHg in the @entity1564 group), with a majority of @entity1 needing two drugs. Fasting levels of both serum insulin and plasma @entity413 increased in the @entity918 group in contrast to unaffected levels in the @entity1564 group. @entity6 was diagnosed in nine @entity1 during follow-up, in eight @entity1 in the @entity918 group (4.1%) and in one @entity1 (0.5%) in the @entity1564 group (P = 0.030). Triglycerides increased and high-density lipoprotein- @entity165 decreased more in the @entity918 group than in the @entity1564 group. Both the low-density lipoprotein/high-density lipoprotein and the apolipoprotein B/apolipoprotein A-I ratios increased in the @entity918 group. At 12 months, 18 @entity1 in the @entity918 group versus five in the @entity1564 group had a ' @entity209 ', as defined by the World Health Organization (P = 0.007) despite 1 year of active blood pressure-lowering therapy. There were less (P = 0.020) adverse events in the @entity1564 group, but no major differences in the subjective symptoms assessment profile. One subject in each group had a @entity583 . CONCLUSION: Antihypertensive treatment with a diuretic, if needed combined with a beta-adrenoceptor blocker, was associated with an aggravated metabolic profile; this was not so for @entity1 treated with an angiotensin-II-receptor blocker, if needed combined with a @entity460 antagonist. An antihypertensive treatment strategy that costs more in the short run but has no metabolic adverse effects may have a health economic impact in the long term.

Metabolic outcome during 1 year in newly detected XXXX : results of the Antihypertensive Treatment and Lipid Profile in a North of Sweden Efficacy Evaluation (ALPINE study).

@entity1 :: ('9606', 'Species') :: ['patients', 'patient', 'men'] @entity101 :: ('MESH:D006973', 'Disease') :: ['hypertension'] @entity6 :: ('MESH:D003920', 'Disease') :: ['Diabetes mellitus'] @entity918 :: ('MESH:D006852', 'Chemical') :: ['hydrochlorothiazide'] @entity10202 :: ('MESH:D015736', 'Chemical') :: ['felodipine'] @entity1564 :: ('MESH:C081643', 'Chemical') :: ['candesartan'] @entity460 :: ('MESH:D002118', 'Chemical') :: ['calcium'] @entity209 :: ('MESH:D008659', 'Disease') :: ['metabolic syndrome'] @entity583 :: ('MESH:D009203', 'Disease') :: ['myocardial infarction'] @entity2165 :: ('MESH:D001262', 'Chemical') :: ['atenolol'] @entity413 :: ('MESH:D005947', 'Chemical') :: ['glucose'] @entity165 :: ('MESH:D002784', 'Chemical') :: ['cholesterol']
@entity101 :: (MESH:D006973,Disease) :: ['hypertensives']
