Beta blockers and hyperlipidaemia

• tend to result in an increase in triglyceride level (via an increase in VLDL) and a reduction in HDL
  • increase in VLDL appears to be result of reduced clearance of triglyceride-rich lipoproteins (possibly via direct effect on lipoprotein lipase or perhaps because of diversion of blood flow from sites rich in lipoprotein lipase e.g. muscle vascular bed)
• do not appear to affect total cholesterol or LDL cholesterol
• if a patient has a predisposition to hypertriglyceridaemia then beta blocker effect can be marked

Labetalol, which posseses both alpha and beta-blocking activity, is reported to have little effect on serum lipids. Also beta-blockers with intrinsic sympathomimetic activity e.g. acebutolol and oxprenolol, are reported to have little effect on serum lipids.