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Related Experiment Videos

Do beta-blockers alter lipids and what are the consequences?

E Holtzman1, T Rosenthal, U Goldbourt

  • 1Department of Medicine, Chaim Sheba Medical Center, Tel Hashomer, Israel.

Journal of Cardiovascular Pharmacology
|January 1, 1987
PubMed
Summary

Antihypertensive drugs impact coronary risk differently. Chlorthalidone increased lipids and slightly lowered heart attack risk, while metoprolol had no lipid changes but favorably reduced coronary heart disease risk.

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Area of Science:

  • Cardiology
  • Pharmacology
  • Preventive Medicine

Background:

  • Antihypertensive therapy can unpredictably affect coronary risk via lipid level alterations.
  • This lipid-altering effect is a growing concern, especially for young hypertensive patients requiring long-term treatment.
  • Different antihypertensive medications exhibit varied impacts on lipid profiles.

Purpose of the Study:

  • To compare the effects of chlorthalidone and metoprolol on fasting plasma lipids and lipoproteins in patients with mild hypertension.
  • To assess the implications of these lipid changes on coronary heart disease (CHD) risk.

Main Methods:

  • Two similar nonrandomized groups of mild hypertension patients were treated with either chlorthalidone or metoprolol.
  • Fasting plasma lipid and lipoprotein levels were measured before and after treatment.

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  • The Israel Ischemic Heart Disease Study data were applied to estimate changes in myocardial infarction and CHD risk.

    • Main Results:

    • Chlorthalidone increased total cholesterol (8.1%), LDL cholesterol, and triglycerides (16%), while decreasing HDL cholesterol (10%, not significant).
    • Metoprolol did not alter total, LDL, or HDL cholesterol levels but increased triglycerides (22%).
    • Chlorthalidone showed a minimal decrease in estimated 5-year myocardial infarction probability, whereas metoprolol demonstrated a favorable influence on calculated CHD risk.

    Conclusions:

    • Different antihypertensive therapies for mild hypertension carry varying significance for coronary heart disease risk.
    • Metoprolol appears to offer a more favorable impact on CHD risk compared to chlorthalidone, considering lipid profile changes.
    • Medication choice for mild hypertension should incorporate potential effects on lipid levels and overall cardiovascular risk.