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A Randomized, Double-blind, Placebo-Controlled Crossover Study

Norman Campbell, MD; Rollin Brant, PhD; Helga Stalts, RN; James Stone, MD; Houman Mahallati, MD

Arch Intern Med. 1998;158:1461-1463.

Background  Acute decreases in intravascular volume are associated with increases in lipid levels. Furosemide causes acute changes in intravascular volume during prolonged therapy but is thought to have little effect on lipid levels.

Methods  To determine if there are daily acute rises in lipid and lipoprotein levels associated with changes in intravascular volume during long-term furosemide ingestion therapy, we performed a randomized, double-blind, placebo-controlled crossover study in 10 patients.

Results  In the 8 hours after furosemide ingestion there were increases in levels of plasma cholesterol (10.1%; P =.001), high-density lipoprotein cholesterol (9.0%; P=.006), and apolipoprotein B (9.8%; P =.003). The increases in levels of triglycerides (11.5%; P=.17) and apolipoprotein A-1 (13.3%; P=.051) were of similar magnitude but more variable and did not achieve statistical significance. There was no substantial change in the total cholesterol–high-density lipoprotein cholesterol ratio (0.6%; 95% CI,-0.74% to 8.6%; P=.88).

Conclusion  This study indicates that there are acute increases in lipid levels after furosemide ingestion during prolonged therapy, which could affect the interpretation of lipid levels and cardiovascular risk in patients.

From the Divisions of General Internal Medicine, Geriatrics, and Nephrology and the Departments of Pharmacology and Therapeutics (Dr Campbell), the Community Health Sciences (Dr Brant), the Division of Cardiology and the Department of Medicine (Drs Campbell, Stone, and Mahallati and Ms Stalts), and the Cardiovascular Research Group (Drs Campbell and Stone), the Faculty of Medicine, the University of Calgary, Calgary, Alberta.

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