Lisinopril and hydrochlorothiazide side effects
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Side Effects of Lisinopril and Hydrochlorothiazide
Common Side Effects of Lisinopril and Hydrochlorothiazide Combination
The combination of lisinopril, an angiotensin-converting enzyme (ACE) inhibitor, and hydrochlorothiazide, a thiazide diuretic, is commonly used to treat hypertension. Clinical trials have shown that this combination is generally well-tolerated, but it does come with some side effects. The most frequently reported side effects include dizziness (7.5%), headache (5.2%), cough (3.9%), fatigue (3.7%), orthostatic effects (3.2%), diarrhea (2.5%), nausea (2.2%), and upper respiratory tract infection (2.2%).
Metabolic Side Effects
The combination therapy can also affect metabolic parameters. For instance, hydrochlorothiazide has been associated with increased serum glucose and uric acid levels, while lisinopril can mitigate some of these adverse metabolic effects. Specifically, hydrochlorothiazide tends to lower serum potassium levels, which can be a concern for patients at risk of hypokalemia . Conversely, lisinopril tends to increase serum potassium levels, which can counterbalance the potassium-lowering effect of hydrochlorothiazide.
Cardiovascular and Hemodynamic Effects
Both lisinopril and hydrochlorothiazide effectively lower blood pressure, but they have different impacts on heart rate and other cardiovascular parameters. Lisinopril has been shown to decrease heart rate over long-term treatment, whereas hydrochlorothiazide can increase heart rate during short-term use. Additionally, lisinopril may have favorable effects on blood rheology, potentially reducing the risk of atherosclerotic and thrombotic complications.
Specific Side Effects in Different Populations
In obese hypertensive patients, lisinopril and hydrochlorothiazide have been found to be equally effective in lowering blood pressure. However, hydrochlorothiazide significantly increased plasma glucose levels, which could be a concern for patients at risk of metabolic disorders. Furthermore, the combination of lisinopril and hydrochlorothiazide has been shown to be more effective than either drug alone in reducing blood pressure, but it also comes with a higher incidence of mild side effects.
Long-Term Safety and Tolerability
Long-term studies indicate that the combination of lisinopril and hydrochlorothiazide is well-tolerated over extended periods. Side effects such as dizziness, headache, and cough are relatively infrequent causes for withdrawal from treatment. Additionally, the combination therapy has been shown to be effective in maintaining blood pressure control over a 52-week period, with side effects remaining mild and subsiding spontaneously.
Conclusion
The combination of lisinopril and hydrochlorothiazide is effective in treating hypertension and is generally well-tolerated. Common side effects include dizziness, headache, and cough, while metabolic side effects such as changes in serum glucose and potassium levels are also observed. The combination therapy offers advantages in blood pressure control but requires careful monitoring of metabolic parameters, especially in patients at risk of metabolic disorders. Overall, this combination remains a viable option for managing hypertension, with a favorable safety profile over long-term use.
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