Effects of different beta-blockers on lipid metabolism in chronic therapy of hypertension.
The aim of this study was to evaluate the possible time-related effects of long-term monotherapy with different beta-blockers on plasma lipids in patients with essential hypertension. We studied 69 mild-moderate hypertensives, all males, aged 35-56 years belonging to the same working community. After 1-month placebo period, patients were assigned to receive propranolol 160 mg/day or atenolol 100 mg/day or bisoprolol 10 mg/day or mepindolol 10 mg/day. They were followed-up for 2 years. Blood pressure (BP), heart rate and blood samples for evaluation of total cholesterol (TC), LDL-cholesterol (LDL-C), triglycerides (TG) and HDL-cholesterol (HDL-C) were taken before and after placebo period and every 6 months from the beginning of the active treatment. All beta-blockers caused similar reduction in BP values which persisted throughout the study. None of the beta-blockers significantly affected TC and LDL-C. Propranolol caused the most pronounced changes in TG (+35-43%) and in HDL-C (-36-44%). Atenolol had the same qualitative effects but to a lesser extent (TG: +26-30%; HDL: -15-25%). Bisoprolol has more beta 1-selective than atenolol, and mepindolol, non-selective with ISA, increased TG (+15-28% and +13-23%) but did not significantly affect HDL-C. Consequently, HDL-C and TG changes appeared to be related to the ancillary properties of the different beta-blockers and, in a lesser degree, to the duration of therapy.
Fogari
R
R
Department of Internal Medicine and Therapeutics, I.R.C.C.S. Policlinico S. Matteo, University of Pavia, Italy.
Zoppi
A
A
Pasotti
C
C
Poletti
L
L
Tettamanti
F
F
Maiwald
C
C
D000319:Adrenergic beta-Antagonists / Q000494:pharmacology* / Q000627:therapeutic use; D000328:Adult; D001794:Blood Pressure / Q000187:drug effects; D008076:Cholesterol, HDL / Q000097:blood; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000378:metabolism; D050356:Lipid Metabolism; D008066:Lipolysis / Q000187:drug effects; D008297:Male; D008875:Middle Aged; D013997:Time Factors; D014280:Triglycerides / Q000097:blood
D000319:Adrenergic beta-Antagonists; D008076:Cholesterol, HDL; D014280:Triglycerides