Association of lipoprotein subclass distribution with use of selective and non-selective beta-blocker medications in patients with coronary heart disease

Abstract

The relationship of beta-blocker drug use to plasma low density lipoprotein-cholesterol (LDL-C), lipoprotein mass distribution, (LDL, S f0–12), intermediate density lipoproteins (IDL, S f12–20), very low density lipoproteins (VLDL, S f20–400), and high density lipoproteins (HDL, F 1.20–9) were examined in 206 men with coronary heart disease. Thirty-three used non-selective (NSEL), 49 used selective (SEL), and were compared to 124 who used no beta-blockade (NoBB). No significant between group differences were seen for potentially confounding variables. LDL and IDL mass, total cholesterol and LDL-cholesterol were not significantly different between groups. HDL-C was significantly lower in both NSEL ( P < 0.005) and SEL ( P < 0.01). NSEL and SEL had significantly lower HDL mass ( P < 0.005 and P < 0.02), HDL 2 mass ( P < 0.01 and P = 0.06), and HDL 3 mass ( P < 0.01 and P < 0.05). VLDL mass was significantly higher ( P < 0.02) only in NSEL. Small LDL (S f0–7) was not significantly different between groups and large LDL (S f7–12) was significantly lower in NSEL ( P < 0.05) and SEL ( P < 0.05). LDL peak S f was significantly lower in both NSEL ( P < 0.005) and SEL ( P < 0.02) compared to NoBB. Despite the lack of differences in levels of LDL-cholesterol, beta-blocker use is associated with a significant difference in the distribution of larger, more buoyant to smaller, more dense LDL particles. Reduced HDL levels in subjects on beta-blockade therapy are associated with reductions in both HDL 2 and HDL 3 subclasses. These results suggest that beta-blocker use may predispose to expression of a relatively atherogenic lipoprotein subclass profile