Atenolol and metoprolol: comparison of effects on blood pressure and serum lipoproteins, and side effects

Eur J Clin Pharmacol. 1983;24(5):573-7. doi: 10.1007/BF00542203.


Several beta-blockers increase VLDL-TG and decrease HDL-cholesterol concentrations. The underlying mechanism is not yet clear. Some studies have suggested that the effect is less pronounced during treatment with selective beta-blockers. The effects of 2 such drugs, metoprolol 200 mg/day and atenolol 50 mg/day, have been compared in 50 hypertensive patients (WHO Stage I-II), mean age 47 years. Serum lipoproteins were determined in 20 patients before treatment and after treatment with either drug for 3 months. Both drugs were equally effective in reducing blood pressure. After atenolol the initial VLDL-cholesterol concentration of 1.04 mmol/l had not changed, but it rose to 1.29 mmol/l after metoprolol (p less than 0.05). The HDL-cholesterol concentration 1.42 mmol/l did not fall during atenolol treatment, but during metoprolol there was a small reduction to 1.31 mmol/l (p less than 0.05). Hyperlipoproteinaemia is common in hypertensive patients, 40% of the present group had hypertriglyceridaemia and 25% had hypercholesterolaemia. Thus, atenolol 50 mg was found not to affect lipoproteins, whereas metoprolol 200 mg increased the VLDL concentration in 75% of the patients.

Publication types

  • Clinical Trial
  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Atenolol / adverse effects
  • Atenolol / pharmacology*
  • Blood Pressure / drug effects*
  • Cholesterol / blood
  • Cholesterol, HDL
  • Female
  • Humans
  • Lipoproteins / blood*
  • Lipoproteins, HDL / blood
  • Lipoproteins, VLDL / blood
  • Male
  • Metoprolol / adverse effects
  • Metoprolol / pharmacology*
  • Middle Aged
  • Propanolamines / pharmacology*
  • Triglycerides / blood


  • Cholesterol, HDL
  • Lipoproteins
  • Lipoproteins, HDL
  • Lipoproteins, VLDL
  • Propanolamines
  • Triglycerides
  • very low density lipoprotein triglyceride
  • Atenolol
  • Cholesterol
  • Metoprolol