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

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      The relationship of beta-blocker drug use to plasma low density lipoprotein-cholesterol (LDL-C), lipoprotein mass distribution, (LDL, Sf0–12), intermediate density lipoproteins (IDL, Sf12–20), very low density lipoproteins (VLDL, Sf20–400), and high density lipoproteins (HDL, F1.20–9) 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), HDL2 mass (P < 0.01 and P = 0.06), and HDL3 mass (P < 0.01 and P < 0.05). VLDL mass was significantly higher (P < 0.02) only in NSEL. Small LDL (Sf0–7) was not significantly different between groups and large LDL (Sf7–12) was significantly lower in NSEL (P < 0.05) and SEL (P < 0.05). LDL peak Sf 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 HDL2 and HDL3 subclasses. These results suggest that beta-blocker use may predispose to expression of a relatively atherogenic lipoprotein subclass profile


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