A 52-year-old man with hypertension and hypertriglyceridemia is started on a non-selective beta-blocker. After three months, his lipid profile shows worsening triglycerides. Which mechanism explains the adverse effect of non-selective beta-blockers on lipid metabolism?
- A Unopposed alpha-mediated hepatic lipogenesis
- B Enhanced HMG-CoA reductase activity
- C Inhibition of lipoprotein lipase due to blockade of beta-2-mediated peripheral vasodilation ✓
- D Increased LDL receptor expression
Correct answer: C. Inhibition of lipoprotein lipase due to blockade of beta-2-mediated peripheral vasodilation
Explanation
Non-selective beta-blockers reduce lipoprotein lipase activity by blocking beta-mediated vasodilation in skeletal muscle, impairing triglyceride clearance. They typically raise triglycerides by 20-50 percent and lower HDL. Cardio-selective beta-1 blockers without ISA have less effect, but non-selective agents worsen lipid profiles.
Reference: Katzung's Basic and Clinical Pharmacology, 15th ed.
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