Effect of beta-1-blocker, nebivolol, on central aortic pressure and arterial stiffness in patients with essential hypertension

Radhika, S.; Naidu, M. U. R.; Raju, Sree Bhushan; Prasad, A. Krishna; Rao, T Ramesh Kumar

doi:10.4103/0253-7613.96349

Cited by 23 publications

(19 citation statements)

References 17 publications

(27 reference statements)

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“…Reductions in arterial stiffness with nebivolol [Agabiti-Rosei et al 2009;Dhakam et al 2008;Soanker et al 2012] and lifestyle modification [Cooper et al 2012;Hughes et al 2012] have been reported previously. Our findings extend previous observations and indicate that the combination of the two interventions are not additive or synergistic in reducing larger artery stiffness, i.e., β-stiffness index.…”

Section: Discussionsupporting

confidence: 65%

“…The results of previous studies also suggest that nebivolol is efficacious in reducing arterial stiffness in hypertensive adults [Agabiti-Rosei et al 2009;Dhakam et al 2008;Soanker et al 2012] although these reports are based on indirect, blood pressure (BP)-dependent indices. Whether nebivolol reduces large artery stiffness independent of reductions in BP is unclear.…”

Section: Introductionmentioning

confidence: 99%

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Singular and combined effects of nebivolol and lifestyle modification on large artery stiffness in hypertensive adults

Werner

Boutagy

Osterberg

et al. 2013

Therapeutic Advances in Cardiovascular Disease

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Background:We hypothesized that the combination of nebivolol and lifestyle modification would reduce large artery stiffness in middle-aged and older hypertensive adults more than either intervention alone. Methods: To address this, 45 men and women (age 40-75 years) with stage I hypertension were randomized to receive either nebivolol (NB; forced titration to 10 mg OD; n = 15; age 57.2 ± 11.4 years; body mass index [BMI] 30.8 ± 5.8 kg/m 2 ), lifestyle modification (LM; 5-10% weight loss via calorie restriction and physical activity; n = 15; age 52.7 ± 8.5 years; BMI 33.9 ± 7.2 kg/m 2 ) or nebivolol plus lifestyle modification (NBLM; n = 15; age 58.9 ± 9.4 years; BMI 32.5 ± 4.9 kg/m 2 ) for 12 weeks. β-stiffness index, a blood-pressure-independent measure of arterial stiffness, and arterial compliance were measured via high-resolution ultrasound and tonometry at baseline and after the 12-week intervention. There was no difference between groups in age, body weight or composition, blood pressure, or in β-stiffness index or arterial compliance at baseline (all p > 0.05). Results: Following the 12-week intervention, body weight decreased ~5% (p < 0.05) in the LM and NBLM groups but did not change from baseline in the NB group (p > 0.05). Supine brachial and carotid systolic and diastolic blood pressure declined following treatment in each of the groups (p < 0.05). However, the magnitude of reduction was not different (p < 0.05) between groups. β-stiffness index declined (-2.03 ± 0.60, -1.87 ± 0.83 and −2.51 ± 0.90 U) and arterial compliance increased similarly (both p > 0.05) in the NB, LM and NBLM groups, respectively. Conclusion: In summary, our findings indicate that the combination of nebivolol and lifestyle modification reduced large artery stiffness to a similar degree as either intervention alone in middle-aged and older hypertensive adults.

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Section: Discussionsupporting

confidence: 65%

Section: Introductionmentioning

confidence: 99%

Singular and combined effects of nebivolol and lifestyle modification on large artery stiffness in hypertensive adults

Werner

Boutagy

Osterberg

et al. 2013

Therapeutic Advances in Cardiovascular Disease

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“…W opublikowanych w ostatnim czasie badaniach klinicznych porównano wpływ nebiwololu i klasycznych b-adrenolityków na parametry centralnego ciś-nienia tętniczego i udowodniono istotną przewagę nebiwololu [17][18][19].…”

Section: Porównanie Wpływ Nebiwololu I Klasycznych B-adrenolityków Naunclassified

“…stwierdzili, że nebiwolol stosowany u chorych z nadciśnieniem w dawce 5 mg nie tylko obniżał ciśnienie centralne, ale także korzystnie wpływał na wszystkie parametry elastyczności naczyń [19]. Ostatnio Kampus i wsp.…”

Section: Porównanie Wpływ Nebiwololu I Klasycznych B-adrenolityków Naunclassified

Protective effect of nebivolol to prevent target organ damage in hypertension

Widecka

2018

Arterial Hypertension

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StreszczeniePowikłania sercowo-naczyniowe (przerost lewej komory, migotanie przedsionków, niewydolność serca, incydenty wieńcowe, starzenie się naczyń i przyspieszona miażdżyca) są główną przyczyną zgonów u chorych z nadciśnieniem tętniczym. Stres oksydacyjny i aortalne ciśnienie centralne odgrywają kluczową rolę w patofizjologii systemu sercowo-naczyniowego oraz powikłań sercowo-naczyniowych. Leki przeciwnadciśnieniowe, nawet w obrębie tej samej klasy, wywierają różny wpływ na wskaźniki sztywności tętnic i funkcję śródbłonka. Nebiwolol jest b-adrenolitykiem trzeciej generacji o działaniu wazodylatacyjnym. W jego funkcji rozszerzającej naczynia pośredniczy szlak śródbłonkowej L-argininy/ /tlenku azotu (NO). Nebiwolol zwiększa biodostępność tlenku azotu. W ostatnich badaniach wykazano, że nebiwolol poprawia elastyczność naczyń w stopniu większym niż konwencjonalne b-adrenolityki (atenolol, metoprolol). Według wytycznych ESH/ESC 2013 niektóre b-adrenolityki o działaniu rozszerzającym naczynia, takie jak celiprolol, karwedilol i nebiwolol, zmniejszają ciśnienie centralne tętna i sztywność tętnic lepiej niż atenolol i metoprolol. Słowa kluczowe: nebiwolol, nadciśnienie, uszkodzenia narządowe, ciśnienie centralne Arterial Hypertens. 2018, vol. 22, no. 1, pages: 1-8 Abstract Clinical organ damage in the cardiovascular (left ventricular hypertrophy, atrial fibrillation, heart failure, coronary events, increased stiffness and atherosclerotic changes) are the major cause of death among patients with hypertension. Oxidative stress and aortic central pressure plays a key role in the pathophysiology of the cardiovascular system and cardiovascular outcome. Antihypertensive agents may, even within the same class, exert variable effects on arterial stiffness variables and endothelial function. Nebivolol is a third-generation b-blocker with vasodilator activity. Its vasodilatory function is mediated by the endothelial L-arginine/NO pathway. Nebivolol increases the bioavailability of NO in the vasculare. In recent studies, nebivolol was demonstrated to improve artery stiffness to a greater extent than impact than conventional b-adrenolitics (atenolol, metoprolol). According to guidelines ESH/ESC some of the vasodilatating b-adrenolitics, such as celiprolol, carvedilol and nebivolol, are reducing central pulse pressure and aortic stiffness better than atenolol or metoprolol.

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“…Наличие убедительной доказательной базы эф-фективности действия небиволола при лечении боль-ных с АГ, ИБС и ХСН объясняет появление на фарма-цевтическом рынке все большего числа его воспроиз-веденных препаратов [5][6][7].…”

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Comparative Pharmacokinetics and Effect on the Hemodynamics of Original and Generic Nebivolol in Healthy Volunteers

Bambysheva¹,

Isaeva²,

Makhinova³

et al. 2016

Racionalʹnaâ farmakoterapiâ v kardiologii

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Aim. To study the pharmacokinetics and effect on hemodynamic parameters of the original and a generic nebivolol in healthy volunteers in the fasting state. Material and methods. 18 healthy volunteers were included into the randomized open study on cross-balanced design. They received single dose (5 mg) of two compared preparations of nebivolol under fasting condition. The concentration of unchanged nebivolol in blood plasma was determined by gas chromatography-tandem mass spectrometry. Calculation of pharmacokinetic parameters and assessment of the hemodynamic were performed. Results. The concentrations of nebivolol after the original and generic drugs intake did not differ significantly in any time point (AUC 0-∞ 41.09±46.82 vs 47.16±66.58 ng•hr/mL and T 1/2 30.84±10.78 vs 29.59±12.08 hours, respectively). Blood pressure reduction was slightly more pronounced when taking generic nebivolol, while the reduction in heart rate at 2 and 4 hours -after original nebivolol intake. Conclusion. A comparative pharmacokinetic study of the genetic nebivolol showed its bioequivalence to the original drug. The effect on hemodynamic parameters with single dose (5 mg) of generic and original nebivolol in healthy volunteers was comparable.

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Effect of beta-1-blocker, nebivolol, on central aortic pressure and arterial stiffness in patients with essential hypertension

Cited by 23 publications

References 17 publications

Singular and combined effects of nebivolol and lifestyle modification on large artery stiffness in hypertensive adults

Singular and combined effects of nebivolol and lifestyle modification on large artery stiffness in hypertensive adults

Protective effect of nebivolol to prevent target organ damage in hypertension

Comparative Pharmacokinetics and Effect on the Hemodynamics of Original and Generic Nebivolol in Healthy Volunteers

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