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 increases serum triglyceride levels and decreases serum high-density lipoprotein (HDL) cholesterol levels. We investigated the effects of propranolol administered for 3 to 44 months on serum lipids in a study of 245 elderly patients with complex ventricular arrhythmias, heart disease (65% with prior Q-wave myocardial infarction and 35% with hypertensive heart disease) and a left ventricular ejection fraction ≥40%. A total of 123 patients were randomized to receive propranolol 85 ± 28 mg daily and 122 patients to no antiarrhythmic drug. Serum lipids were determined before randomization; at 3, 6, 12, 18, 24, 30, 36, and 42 months after randomization; and at the end of the study. Five patients stopped taking propranolol before follow-up serum lipid measurements were recorded at 3 months. Ninety-nine patients were alive at the end of the study. The mean follow-up time was 29 ± 15 months, in the group receiving propranolol; no significant differences were found in serum total cholesterol, low-density lipoprotein (LDL) cholesterol, HDL cholesterol, total cholesterol:HDL cholesterol ratio, or triglyceride levels before or after treatment. The mean follow-up time was 27 ± 15 months in patients who received no antiarrhythmic drug; there was a significant reduction in serum total cholesterol (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 marginally significant increase in serum HDL cholesterol (3%, P = 0.054) in these patients.