The effects of cardioselective vasodilating beta-blockers on lipids.

Ideally, an antihypertensive agent should have a neutral effect or, preferably, produce a favorable shift in the serum lipid and lipoprotein profile, which is associated with a decrease in coronary heart disease risk. The thiazides and loop diuretics increase total lipid levels, low-density lipoprotein (LDL) cholesterol, and triglycerides. beta-Blockers without beta 2-agonist properties increase triglycerides and decrease high-density lipoprotein (HDL) cholesterol levels. Calcium antagonists, angiotensin converting enzyme inhibitors, and combined alpha/beta-blockers are generally thought to have little effect on the lipid profile, although some studies have indicated a modest beneficial effect. alpha-Adrenoceptor antagonists are known to reduce LDL cholesterol levels modestly and to increase HDL cholesterol levels. The overall results of the currently available studies with celiprolol, a selective beta 1-antagonist with ancillary beta 2-agonist and vasodilating properties, indicate a favorable effect of the drug on serum lipid and lipoprotein profiles.