ASSOCIATION OF LIPOPROTEIN SUBCLASS DISTRIBUTION WITH USE OF SELECTIVE AND NONSELECTIVE BETA-BLOCKER MEDICATIONS IN PATIENTS WITH CORONARY HEART-DISEASE

The relationship of beta-blocker drug use to plasma low density lipopr otein-cholesterol (LDL-C), lipoprotein mass distribution, (LDL, S(f)0- 12), intermediate density lipoproteins (IDL, S(f)12-20), very low dens ity lipoproteins (VLDL, S(f)20-400), and high density lipoproteins (HD L, F(1.2)0-9) were examined in 206 men with coronary heart disease. Th irty-three used non-selective (NSEL), 49 used selective (SEL), and wer e compared to 124 who used no beta-blockade (NoBB). No significant bet ween group differences were seen for potentially confounding variables . LDL and IDL mass, total cholesterol and LDL-cholesterol were not sig nificantly different between groups. HDL-C was significantly lower in both NSEL (P < 0.005) and SEL (P < 0.01). NSEL and SEL had significant ly 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 signific antly higher (P < 0.02) only in NSEL. Small LDL (S(f)0-7) was not sign ificantly different between groups and large LDL (S(f)7-12) was signif icantly lower in NSEL (P < 0.05) and SEL (P < 0.05). LDL peak Sf was s ignificantly lower in both NSEL (P < 0.005) and SEL (P < 0.02) compare d to NoBB. Despite the lack of differences in levels of LDL-cholestero l, beta-blocker use is associated with a significant difference in the distribution of larger, more buoyant to smaller, more dense LDL parti cles. Reduced HDL levels in subjects on beta-blockade therapy are asso ciated with reductions in both HDL2 and HDL3 subclasses. These results suggest that beta-blocker use may predispose to expression of a relat ively atherogenic lipoprotein subclass profile.