Beta blockers and hyperlipidaemia

Non-selective beta blockers only modestly alter blood lipid profiles. They typically raise triglyceride levels (by roughly 15% to 25%) and lower high-density lipoprotein (HDL) cholesterol by about 5% to 10%. They generally have little to no direct effect on total cholesterol or low-density lipoprotein (LDL) cholesterol.

Any increase in VLDL appears to be the result of reduced clearance of triglyceride-rich lipoproteins (possibly via direct effect on lipoprotein lipase or perhaps because of diversion of blood flow from sites rich in lipoprotein lipase e.g. muscle vascular bed)

If a patient has a predisposition to hypertriglyceridaemia then the beta blocker effect can be more marked.

Reference

1. do Vale GT et al. Three Generations of β-blockers: History, Class Differences and Clinical Applicability. Curr Hypertens Rev. 2019;15(1):22-31