Related Experiment Videos
Effects of celiprolol and other antihypertensive agents on serum lipids and lipoproteins
1Department of Medicine and Pharmacology, University of Minnesota, Minneapolis 55455.
Insights
Antihypertensive medications can impact lipid levels, with some diuretics and beta-blockers negatively affecting cholesterol and triglycerides. Favorable lipid profiles were observed with certain vasodilatory beta-blockers and alpha-blockers.
Area of Science:
- Cardiology
- Pharmacology
- Metabolic Research
Background:
- Intervention trials with antihypertensive agents have not shown the expected reduction in coronary heart disease (CHD) morbidity and mortality.
- Focus has shifted to the effects of these agents on lipid and lipoprotein profiles.
Purpose of the Study:
- To review the effects of various antihypertensive agents on lipid and lipoprotein levels.
- To identify which classes of antihypertensive drugs may have adverse or favorable impacts on cardiovascular risk factors beyond blood pressure reduction.
Main Methods:
- Literature review and analysis of existing clinical trial data.
- Categorization of antihypertensive agents based on their pharmacological class and effects on lipids.
Main Results:
- Diuretics (thiazides, loop diuretics) and non-selective beta-blockers generally increase triglycerides and LDL cholesterol, or decrease HDL cholesterol.
- Beta-blockers with intrinsic sympathomimetic activity showed no significant lipid alterations.
- Celiprolol (a beta-blocker with vasodilatory effects) and alpha 1-adrenergic blockers demonstrated favorable effects on lipid profiles.
- Other common antihypertensive agents had no significant impact on lipid and lipoprotein levels.
Conclusions:
- The lipid and lipoprotein effects of antihypertensive agents vary significantly by drug class.
- Certain antihypertensive drugs may have pleiotropic effects influencing cardiovascular risk through mechanisms beyond blood pressure lowering.
- Careful consideration of lipid profiles is warranted when selecting antihypertensive therapy.
Abstract:
The expected reduction in coronary heart disease morbidity and mortality has not been observed in intervention trials with antihypertensive agents, and attention has focused on the lipid and lipoprotein effects of antihypertensive agents. Diuretics, especially thiazides, chlorthalidone, and the loop diuretics, increase total and low-density lipoprotein cholesterol and triglyceride levels with generally no significant change in high-density lipoprotein cholesterol. Selective and nonselective beta-blockers decrease high-density lipoprotein cholesterol and increase triglyceride levels, whereas those with intrinsic sympathomimetic activity do not significantly alter lipid and lipoprotein levels. Celiprolol, a beta-blocker with vasodilatory effects, appears to favorably affect lipid and lipoprotein levels as do the alpha 1-adrenergic blockers. The other commonly used antihypertensive agents do not produce significant effects.