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Beta-blocker induced changes in the cholesterol: high-density lipoprotein cholesterol ratio and risk of coronary

B G Woodcock, N Rietbrock

    Klinische Wochenschrift
    |September 17, 1984
    PubMed

    Insights

    Beta-blocker hypertension drugs may increase heart attack risk by negatively impacting cholesterol levels. Specific beta-blockers like pindolol or labetalol may avoid these adverse effects on lipoproteins.

    Area of Science:

    • Cardiology
    • Pharmacology

    Background:

    • Beta-blocker therapy for hypertension shows limited impact on coronary heart disease (CHD) mortality.
    • Concerns exist that adverse changes in plasma lipoproteins may negate blood pressure reduction benefits.

    Purpose of the Study:

    • To investigate the effects of commonly used beta-blockers on plasma lipoprotein concentrations in hypertensive patients.
    • To determine if these effects offset the benefits of blood pressure reduction.

    Main Methods:

    • Comparison of plasma lipoprotein concentrations in hypertensive patients treated with beta-blockers versus patients with coronary heart disease.
    • Analysis of changes in total cholesterol (TC), high-density lipoprotein cholesterol (HDLC), and the TC:HDLC ratio.

    Main Results:

    • Commonly used beta-blockers cause significant shifts in the TC:HDLC ratio and reduce atheroprotective HDLC.
    • These changes can increase heart attack risk two- to four-fold.
    • Beta-blockers with intrinsic sympathomimetic activity (pindolol) or alpha-beta-blocking properties (Labetalol) appear to lack adverse lipoprotein effects.

    Conclusions:

    • Chronic treatment with most beta-blockers necessitates monitoring of cholesterol and HDLC.
    • Lipoprotein measurements are crucial for patients with high initial cholesterol or TC:HDLC ratios.
    • Further studies are needed to assess long-term beta-blocker effects on lipoproteins and coronary events.

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