Effect of verapamil on serum lipoproteins in patients with angina pectoris.

Since several beta-blocking agents increase the atherogenic VLDL-triglycerides and decrease the atheroprotective HDL-cholesterol we studied if verapamil also affects these lipoproteins or the most atherogenic LDL-cholesterol. Twelve patients (three females), mean age 56 years, with angina pectoris or hypertension/tachyarrhythmias were treated with verapamil 240-320 mg/day. Serum lipoproteins were measured before and after 6 and 24 weeks of therapy. Initial total serum cholesterol averaged 7.27 mmol/l. After 6 weeks of treatment it decreased by 9%, p less than 0.02. These results remained significant, p less than 0.01 after 24 weeks. The decrease was due to a fall in LDL-cholesterol by 12%, p less than 0.01. The reduction in LDL-cholesterol was correlated to initial LDL-cholesterol concentration, r = -0.73, p less than 0.01. Within LDL there was a parallel decrease in phospholipids, p less than 0.05. There were no changes in total or VLDL-triglycerides or total HDL-cholesterol. In the HDL fraction HDL2 decreased insignificantly but HDL3 cholesterol increased by 12%, p less than 0.05. We conclude that verapamil has a beneficial effect on serum lipoproteins in that it lowers the atherogenic LDL-cholesterol and does not affect the other lipoproteins in an undesirable way.