METABOLIC CONSEQUENCES OF ATENOLOL AND PROPRANOLOL IN TREATMENT OF ESSENTIAL HYPERTENSION

A six-month study of triglyceride, cholesterol, free fatty acid (FFA), glucose, insulin, growth hormone, and glucagon concentrations was carried out in asymptomatic hypertensive normal-weight men randomly allocated to treatment with atenolol or propranolol. A highly significant increase in the basal plasma triglyceride concentration was observed in propranolol-treated patients after three and six months’ treatment, with a smaller but significant increase in atenolol-treated subjects after six months’ treatment. The changes in triglyceride concentration could not be ascribed to variations in plasma insulin, growth hormone, or glucagon concentrations. Basal FFA concentrations were reduced during the first three months of treatment in both groups but returned to pretreatment levels after six months. Plasma cholesterol concentrations were unchanged by either agent. Propranolol had a greater effect on triglyceride concentrations than atenolol, but probably all beta-blocking agents have similar effects of different magnitudes. These effects should be investigated further in view of the postulated association between plasma triglyceride concentrations and cardiovascular disease. © 1979, British Medical Journal Publishing Group. All rights reserved.