Topical timolol decreases plasma high-density lipoprotein cholesterol level
A. L. Coleman, D. L. Diehl, H. D. Jampel, P. S. Bachorik and H. A. Quigley
Glaucoma Service, Wilmer Ophthalmological Institute, Baltimore, Md.
beta-Adrenergic antagonists taken orally adversely alter plasma lipid
profiles. This study was designed to determine whether 0.5% topical timolol
maleate has a similar effect. Forty volunteers who were not using
medications known to alter plasma lipid levels were recruited for an
unmasked study in which each subject served as his or her own control.
Twelve subjects did not complete the study because of ocular and systemic
side effects or extraneous factors. Twenty-eight subjects used topical
timolol for an average of 76 days, with two 12-hour fasting plasma
specimens obtained at the beginning and end of the period. Mean total
cholesterol and low-density lipoprotein cholesterol levels did not change
significantly with treatment. Triglyceride values increased 12%;
high-density lipoprotein cholesterol levels decreased 9%; and the total
cholesterol-high-density lipoprotein cholesterol ratio increased 8%. Higher
baseline high-density lipoprotein cholesterol levels were associated with
larger reductions in high-density lipoprotein cholesterol levels. Changes
in high-density lipoprotein cholesterol levels of this magnitude have been
estimated to increase the risk of coronary artery disease by 21%.
