EFFECT OF PROPRANOLOL VERSUS NO ANTIARRHYTHMIC DRUG ON SERUM-LIPIDS IN PATIENTS WITH HEART-DISEASE AND COMPLEX VENTRICULAR ARRHYTHMIAS

Propranolol administered to patients for 3 days to 1 year reportedly i ncreases serum triglyceride levels and decreases serum high-density li poprotein (HDL) cholesterol levels. We investigated the effects of pro pranolol administered for 3 to 44 months on serum lipids in a study of 245 elderly patients with complex ventricular arrhythmias, heart dise ase (65% with prior and-wave myocardial infarction and 35% with hypert ensive heart disease) and a left ventricular ejection fraction greater than or equal to 40%. A total of 123 patients were randomized to rece ive propranolol 85 +/- 28 mg daily and 122 patients to no antiarrhythm ic drug, Serum lipids were determined before randomization; at 3, 6, 1 2, 18, 24, 30, 36, and 42 months after randomization; and at the end o f the study. Five patients stopped taking propranolol before follow-up serum lipid measurements were recorded at 3 months. Ninety-nine patie nts were alive at the end of the study. The mean follow-up time was 29 +/- 15 months, in the group receiving propranolol; no significant dif ferences were found in serum total cholesterol, low-density lipoprotei n (LDL) cholesterol, HDL cholesterol, total cholesterol:HDL cholestero l ratio, or triglyceride levels before or after treatment. The mean fo llow-up time was 27 +/- 15 months in patients who received no antiarrh ythmic drug; there was a significant reduction in serum total choleste rol (2%, P = 0.0001), in LDL cholesterol (3%, P = 0.0001), and in the total cholesterol:HDL cholesterol ratio (4%, P = 0.0001); a marginally significant decrease in serum triglycerides (3%, P = 0.052); and a ma rginally significant increase in serum HDL cholesterol (3%, P = 0,054) in these patients,