Effects of two antihypertensive agents on lipids, lipoproteins, and apoproteins A and B. Comparison of prazosin and atenolol.

To compare the effects of prazosin and atenolol on plasma lipid concentrations, 60 patients with arterial hypertension (diastolic 90 to 120 mm Hg, systolic 160 to 200 mm Hg) were allocated at random to one of two treatment groups. The lipid profile included the determination of total cholesterol and triglyceride levels by ultracentrifugation, and assays of apoproteins A1 and B by laser immunonephelometry. Determinations were performed 30 days before and on the first, 90th, and 180th days of treatment. Both drugs had similar reducing effects on blood pressure. A significant decrease in total cholesterol, low-density lipoprotein cholesterol, and apoprotein B, and an increase in high-density lipoprotein cholesterol and apolipoprotein A1 were observed in patients receiving prazosin, whereas patients receiving atenolol exhibited opposite changes in plasma lipids. Although the clinical significance of these findings is uncertain, such metabolic effects should be taken into account when evaluating the risk/benefit ratio of antihypertensive treatments.