Summary
Several β-blockers increase the very low density lipoprotein- triglyceride (VLDL- TG) concentration and decrease the high density lipoprotein (HDL)- cholesterol concentration. The underlying mechanism is unclear. Some studies suggest that the effect is less pronounced during treatment with β1-selective β-blockers.
We compared the effects of 2 such drugs, metoprolol 200 mg/day and atenolol 50 mg/ day, in 20 hypertensive patients (WHO stage I- II). Serum lipoproteins were determined before and after a treatment period with either drug for 3 months. Both drugs were equally effective in reducing blood pressure. Atenolol had no significant effects on serum lipoproteins. During metoprolol treatment significant increases were found for serum TG and VLDL- cholesterol and a significant reduction was found for HDL- cholesterol.
Hyperlipoproteinaemia is common in hypertensive patients; in this group about 50% had hypertriglyceridaemia and 25%, hypercholesterolaemia. Adverse long term effects of β- blockers on serum lipoprotein may theoretically counteract the benefit achieved by nor-malisation of an elevated blood pressure.
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Rössner, S., Weiner, L. A Comparison of the Effects of Atenolol and Metoprolol on Serum Lipoproteins. Drugs 25 (Suppl 2), 322–325 (1983). https://doi.org/10.2165/00003495-198300252-00094
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DOI: https://doi.org/10.2165/00003495-198300252-00094