The Effect of Enalapril and Timolol on Blood Lipids: A Randomized Multicenter Hypertension Study in General Practice in Norway

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Abstract
In a 24-week randomized, single-blind study Timolol (n = 63) and Enalapril (n = 57) proved to be potent and safe antihypertensive drugs. However, the effect on lipid metabolism was fundamentally different, despite the fact that the effect on total serum cholesterol did not significantly differ between the two groups. Enalapril had no adverse effect on any lipid fractions, while Timolol increased very low (VLDL) + low (LDL) density lipoprotein cholesterol by 7.6% (p < 0.001) and total triglycerides by 34.5% (p < 0.001), and decreased the favorable high density lipoprotein (HDL) cholesterol by 11.3% (p < 0.001). Thus, the ratio HDL/VLDL + LDL cholesterol was reduced by 17.1% (p < 0.001). Enalapril reduced uric acid by 3.4% (NS), while Timolol increased uric acid by 4.0% (p < 0.05). The difference between the groups was statistically significant (p < 0.01). The first steps in any attempt to solve the hypertension-coronary dilemma should be to take into consideration all phamacologic effects of antihypertensive drugs.