Atenolol and metoprolol: comparison of effects on blood pressure and serum lipoproteins, and side effects.
Several beta-blockers increase VLDL-TG and decrease HDL-cholesterol concentrations. The underlying mechanism is not yet clear. Some studies have suggested that the effect is less pronounced during treatment with selective beta-blockers. The effects of 2 such drugs, metoprolol 200 mg/day and atenolol 50 mg/day, have been compared in 50 hypertensive patients (WHO Stage I-II), mean age 47 years. Serum lipoproteins were determined in 20 patients before treatment and after treatment with either drug for 3 months. Both drugs were equally effective in reducing blood pressure. After atenolol the initial VLDL-cholesterol concentration of 1.04 mmol/l had not changed, but it rose to 1.29 mmol/l after metoprolol (p less than 0.05). The HDL-cholesterol concentration 1.42 mmol/l did not fall during atenolol treatment, but during metoprolol there was a small reduction to 1.31 mmol/l (p less than 0.05). Hyperlipoproteinaemia is common in hypertensive patients, 40% of the present group had hypertriglyceridaemia and 25% had hypercholesterolaemia. Thus, atenolol 50 mg was found not to affect lipoproteins, whereas metoprolol 200 mg increased the VLDL concentration in 75% of the patients.
D000328:Adult; D001262:Atenolol / Q000009:adverse effects / Q000494:pharmacology*; D001794:Blood Pressure / Q000187:drug effects*; D002784:Cholesterol / Q000097:blood; D008076:Cholesterol, HDL; D005260:Female; D006801:Humans; D008074:Lipoproteins / Q000097:blood*; D008075:Lipoproteins, HDL / Q000097:blood; D008079:Lipoproteins, VLDL / Q000097:blood; D008297:Male; D008790:Metoprolol / Q000009:adverse effects / Q000494:pharmacology*; D008875:Middle Aged; D011412:Propanolamines / Q000494:pharmacology*; D014280:Triglycerides / Q000097:blood
D008076:Cholesterol, HDL; D008074:Lipoproteins; D008075:Lipoproteins, HDL; D008079:Lipoproteins, VLDL; D011412:Propanolamines; D014280:Triglycerides; C030106:very low density lipoprotein triglyceride; D001262:Atenolol; D002784:Cholesterol; D008790:Metoprolol