Effects of beta blockers and other antihypertensive drugs on cardiovascular risk.

The treatment of high blood pressure with beta-blocking and other antihypertensive agents has been associated with a decrease in the incidence of stroke, progression of hypertension, heart failure, left ventricular hypertrophy, retinopathy and renal failure. Although hypertension increases the risk for developing coronary disease, the risk is heightened markedly if coexistent hyperlipidemia, smoking or glucose tolerance is present. Thiazide diuretics, primarily used as antihypertensive agents, compromise glucose tolerance and are associated with increases in plasma cholesterol, triglycerides and low density lipoprotein levels. Nonselective and beta 1-selective beta blockers have also been associated with increases in plasma triglycerides and very low density lipoproteins, as well as with decreases in high density lipoprotein levels. The effects of various antihypertensive agents on lipid levels, lipid metabolism, carbohydrate metabolism, left ventricular size and atherogenesis are discussed.