The possibility that certain antihypertensive drugs produce metabolic alterations in patients with hypertension treated during one year, has been prospectively assessed in 40 patients with essential hypertension with matched age and blood pressure readings. Four groups (Gr) of 10 patients each were studied. Group 1 received 100 mg/day of atenolol (AT), group 2 received 5 mg of amiloride and 50 mg of hydrochlorothiazide (4 tablets per week), group 3 received 40 mg/day of nifedipine retard (NF) and group 4 received 50 mg/day of captopril (CP). The parameters studied prior and after one month of treatment were the following: urea, creatinine, uric acid, Na+, K+, Ca+, total cholesterol, HDL-cholesterol, triglycerides, glycemia, blood pressure (BP), pulse rate (PR) and body weight. Both group 1 and 2 showed significantly increased total cholesterol (p less than 0.001 and p less than 0.01 respectively) as well as decreased HDL levels. In addition, group 2 had significantly increased levels of uric acid, glycemia and triglycerides (p less than 0.01). In the latter groups no significant changes were found within body weight, lipid levels, glycemia, uric acid ruling-out weight gain as a possible cause for these adverse metabolic effects. Pulse rate decreased in group 1. Group 3 pulse rate significantly increased (p less than 0.001) However, no other changes were significant. No significant biochemical or pulse rate readings were found in group 4. BP was best controlled in groups 1, 3 and 4.

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