Beta-adrenoceptor blockade and plasma lipoproteins. Comparison of the effects of propranolol and pindolol on plasma lipoproteins including high-density lipoprotein subfractions

Abstract

Beta-Adrenoceptor blocker therapy is known to cause disturbances of the lipoprotein profile. The long-term effects of beta-adrenoceptor blockers and the influence of intrinsic sympathomimetic activity (ISA) has not been clearly defined. We measured serum lipoproteins during chronic beta-adrenoceptor blockade in patients with stable angina pectoris treated with propranolol (without ISA) (n = 21) or pindolol (with ISA) (n = 19). No significant changes occurred in the lipoprotein profile of the patients taking pindolol. In those taking propranolol, very low density lipoprotein (VLDL) increased at 52 weeks (P less than 0.05) and total high density lipoprotein (HDL) decreased at 26 weeks (P less than 0.01) and at 52 weeks (P less than 0.05). However, HDL2 rose significantly at 52 weeks (P less than 0.05). There was a corresponding increase in HDL2/HDL3 ratio. We conclude that pindolol is less likely to exert a harmful effect on plasma lipoproteins than beta-adrenoceptor blockers without ISA.