Effects of the vasodilating beta-blocker nebivolol on smoking-induced endothelial dysfunction in young healthy volunteers

Abstract

Objective:To assess the effect of nebivolol, a highly selective third generation β 1 -adrenoceptor antagonist with an endothelium-dependent vasodilatory action, on smoking-induced endothelial dysfunction. Research design and methods:This open-label study examined the effect of 14 daily doses of 5 mg nebivolol on forearm blood fl ow in 21 healthy, young, male, light smokers (Յ5 cigarettes/day), measured by plethysmography on Days 1, 7, and 14. The primary endpoint was the difference in forearm blood fl ow after smoking one standard cigarette from baseline (Day 1) until treatment end on Day 14. Secondary outcomes included the difference in forearm blood fl ow between Day 1 and Day 7 compared with Day 14 before and after smoking, the effect of nebivolol on blood coagulation parameters, high-sensitive-C-reactive protein (hs-CRP), and the safety and tolerability of nebivolol. Results: Nebivolol for 14 days did not signifi cantly affect forearm blood fl ow after smoking. On Day 7 of nebivolol treatment, forearm blood fl ow after smoking was signifi cantly greater than blood fl ow before smoking (increase of 0.44 mL/min; p = 0.00656). Serum level of hs-CRP showed a marked decrease from Day 1 to Day 14. No changes in coagulation parameters were observed over the course of nebivolol treatment. Nebivolol was well tolerated throughout the study. Conclusions:The increase in forearm blood fl ow and the marked decrease in hs-CRP over 14 days of treatment suggest that nebivolol has a positive effect on endothelial function in light smokers, but larger studies are required to confi rm these observations.

Cigarette smoking impairs Na+-K+-ATPase activity in the human coronary microcirculation

“…However, it is not clear whether cigarette smokers and nonsmokers had the same treatments for the underlying diseases. It has been shown that treatments for cardiovascular diseases such as statins, ␤-blockers, and angiotensin-converting enzyme inhibitors ameliorate endothelial function not only in patients with the target diseases but also in chronic smokers (6,43,48). While we assume that all patients regardless of cigarette smoking had been treated with medications before surgery that could potentially restore microvascular function, we cannot rule out the possible influence of treatments.…”

Lack of difference between nebivolol/hydrochlorothiazide and metoprolol/hydrochlorothiazide on aortic wave augmentation and central blood pressure

“…Nebivolol/HCTZ and metoprolol/HCTZ both lowered high-density lipoprotein (HDL)cholesterol and increased triglyceride levels, but only metoprolol/HCTZ tended to increase HOMA-IR. Clinical evidence for the vasodilating properties of nebivolol in humans results primarily from forearm blood flow studies [10,11,[30][31][32]. This has been attributed to a decrease in aortic wave augmentation through attenuation of pulse wave reflection by peripheral vasodilatation [12][13][14].…”

Heart rate control with adrenergic blockade: Clinical outcomes in cardiovascular medicine

“…Patients with higher initial values experienced greater reductions in HR and BP compared with patients having moderately elevated initial values 99. In other clinical trials, nebivolol reduced vascular resistance and improved endothelial function in patients with hypertension, and also lowered the levels of the inflammatory marker, high-sensitivity C-reactive protein, in healthy volunteers who smoked cigarettes 100,101…”