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  • Title: Possible biochemical mechanisms involved in the antihypertensive drug-induced changes in serum lipoproteins.
    Author: Lijnen P, Fagard R, Staessen J, Amery A.
    Journal: Methods Find Exp Clin Pharmacol; 1989 Jan; 11(1):17-23. PubMed ID: 2654525.
    Abstract:
    The antihypertensive drug-induced changes in serum lipoproteins can be attributed to two major mechanisms, namely an increased hepatic lipoprotein synthesis and a disturbed lipoprotein catabolism. Thiazides, by inhibiting phosphodiesterase, increase the intracellular concentration of cyclic AMP leading to a stimulation of lipolysis. beta-Blockers may reduce the adenylate cyclase activity in liver cells, leading to a reduced inhibition of the liver triglyceride synthesis and a higher secretion of VLDL triglyceride particles. alpha-Blockade through phosphodiesterase inhibition and an increased cAMP level, can result in a blockade of the liver triglyceride synthesis and a reduced serum triglyceride concentration. Lipoprotein lipase activity is reduced by beta-blockers and stimulated by alpha-blockers, leading, respectively, to a lower and a higher plasma HDL cholesterol. Besides these two major mechanisms, a direct effect of antihypertensive drugs on intracellular cholesterol synthesis can also be postulated.
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