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Acute lipoprotein changes associated with atenolol therapy for hypertension in non-insulin dependent diabetes
M D Feher1, D J Torrens, W Richmond
1Department of Clinical Pharmacology, St. Mary's Hospital Medical School, London, UK.
Insights
Beta-blocker withdrawal in diabetic patients significantly altered lipid profiles, increasing HDL cholesterol and decreasing triglycerides. These changes reversed upon atenolol reintroduction, showing short-term reversibility without affecting blood pressure control.
Area of Science:
- Cardiology
- Endocrinology
- Pharmacology
Background:
- Hypertension and diabetes often coexist, necessitating careful medication management.
- Beta-blockers are commonly used for hypertension, but their effects on lipid profiles in diabetic patients require further investigation.
Purpose of the Study:
- To assess the influence of atenolol withdrawal and reintroduction on lipid and lipoprotein profiles in hypertensive, non-insulin dependent diabetic subjects.
- To determine if atenolol-induced lipid changes are reversible and if they occur independently of blood pressure control.
Main Methods:
- A study involving 11 stable hypertensive non-insulin dependent diabetic subjects.
- A three-week placebo phase followed by atenolol (100mg) reintroduction.
- Monitoring of pulse rate, blood pressure, weight, and lipid/lipoprotein parameters (cholesterol, triglycerides).
Main Results:
- Withdrawal of atenolol led to significant increases in pulse rate, HDL-cholesterol, and HDL2-cholesterol, with a significant decrease in triglycerides.
- Reintroduction of atenolol reversed these lipid and lipoprotein changes.
- Weight and blood pressure remained stable throughout the study.
Conclusions:
- Atenolol-induced lipid and lipoprotein alterations in non-insulin dependent diabetes are reversible in the short term.
- These reversible changes occur without significant alterations in blood pressure control.
- Future research should consider beta-blocker-induced lipoprotein changes in the context of diabetic macrovascular complications.
Abstract:
In a study on 11 stable hypertensive non-insulin dependent diabetic subjects the influence of beta-blocker (atenolol 100mg) withdrawal and reintroduction was assessed. After a three week placebo phase significant increases in pulse rate, high density lipoprotein- and high density lipoprotein2-cholesterol and a significant decrease in triglyceride were observed. Three weeks after recommencement of atenolol therapy the pulse, lipid and lipoprotein changes were reversed and significantly so. Weight and blood pressure remained constant throughout. Results from this study indicate that in non-insulin dependent diabetes, atenolol-induced lipid and lipoprotein changes are reversible in the short term and occur in the absence of significant changes in blood pressure control. The lipoprotein changes observed involved an alteration in high density lipoprotein composition. As a reduced high density lipoprotein cholesterol is associated with macrovascular disease, future studies on the association of lipoproteins and diabetic complications should take into account these changes in lipoproteins with beta-blocker hypotensive therapy.