The Effect of Thiazide Diuretics on Blood Lipid Profile in Hypertensive Adults: A Meta-analysis of Randomized Controlled Trials

This study explores the effect of diuretics use on metabolic markers (i.e., the lipid profile) since thiazide diuretics are extensively used to treat cardiac patients with hypertension (HTN) and other comorbidities. The Embase and PubMed databases were searched for relevant English-language peer-reviewed articles. Different search terms and medical subject headings (MesH) terms were used to find the relevant articles. Our study included randomized controlled trials with hypertensive adult patients in the intervention group receiving thiazide diuretics; controls receiving any other diuretic or any other intervention for HTN where an intention to treat analysis was performed. We collected the demographic details, baseline lipid profile values, and end-of-study lipid profile values of all the participants in the studies along with the standard deviation of each value to calculate the net change effect. Five studies were included. We used the Q-test and I(2) index for heterogeneity and the inverse variance method for weighting. We used the fixed effects model for total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C) because TC and LDL-C had no heterogeneity (I(2) was 0%). We used a random-effects model for triglycerides (TG) and high-density lipoprotein cholesterol (HDL-C), which showed moderate heterogeneity (I(2) was 57.2% and 59.5%, respectively). We used the Cochrane quality assessment to assess the quality level of the included studies. We used a funnel plot to avoid publication bias. Diuretics have a significant effect on lipid profiles. However, because this conclusion is supported by a low number of studies, further research is needed, and physicians are advised to use their best clinical judgment until the relationship between diuretics and lipid profiles seen in this study can be further supported by additional studies.