INTRODUCTION AND BACKGROUND: Coronary artery disease (CAD) is the leading cause of death in adults worldwide and its most important treatable risk factors are diabetes mellitus (DM), dyslipidemia and systemic hypertension (SH). The treatment with anti-hypertensives may cause undesirable changes in lipid profile, which diminishes its beneficial anti-atherogenic effects on the reduction of blood pressure. OBJECTIVE: To evaluate the lipid profile of type 2 diabetic subjects with essential hypertension treated only with captopryl or in combination with other anti-hypertensive drugs in order to show improvement in the lipid pattern of these patients, which leads to a protective effect. MATERIAL AND METHODS: We assessed total cholesterol (TC), HDL cholesterol (HDL-C), LDL cholesterol (LDL-C) and triglycerides (TG) levels of 140 patients, average age 59.7 ± 10.9, of both sexes, with type 2 diabetes and hypertension, referred to UNOESTE Laboratory of Clinical analysis. The glycemic control was determined by glycated hemoglobin (HG) levels. According to metabolic glycemic control (satisfactory or unsatisfactory), these patients were divided into two groups: treated only with captopril (DC); treated with a combination of hydrochlorothiazide (HCTZ) and DC. In patients with GH < 8.8% (controlled), DC and HCZT showed the following levels respectively: total cholesterol (210.2 ± 43.7 and 198.3 ± 37.5), HDL (49 ± 10.9 and 49.2 ± 8.7), LDL (126.9 ± 43.3 and 119.8 ± 23.8), TG (181.9 ± 86.4 and 161.2 ± 83.8) and G (151.3 ± 51.4 and 163 ± 66.5). There were no significant differences among them. In patients with GH > 11.2% (uncontrolled), DC and HCTZ showed the following levels respectively: total cholesterol (214.3 ± 45.9 and 197 ± 49.5), HDL (35.3 ± 20.5 and 41.5 ± 0.7), LDL (121 ± 43.3 and 116.5 ± 38.9), TG (271.5 ± 175.2 and 194 ± 49.5) and G (232.3 ± 102.9 and 272 ± 53.7). There were no significant differences, either. Nonetheless, it was observed in the last group, the combination of captopryl with HCTZ led to lower levels of TG and slightly elevated HDL levels, which shows that the association has a protective effect by reducing the atherosclerotic risk and minimizing the deleterious atherogenic effects of HCTZ.
Lipid profile; Type 2 diabetes mellitus; Hypertension; Captopril
