Metabolic and Antihypertensive Effects of Nebivolol and Atenolol in Normometabolic Patients with Mild-to-Moderate Hypertension

Pesant, Yves; Marc-Aurèle, J; Bielmann, P; Alaupovic, Petar; Cartier, P; Bichet, Daniel G.; Thibault, Gaétan; Lupien, Paul J.

doi:10.1097/00045391-199905000-00004

Cited by 27 publications

(26 citation statements)

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“…Both drugs did not adversely affect the blood sugar level this finding is similar to study conducted by Pessant et al, [12] . But Luc Pioier [13] conducted a study to compare the effects of Nebivolol and Atenolol in 25 ambulatory hypertensive patients with impaired glucose tolerance.…”

Section: Observations and Resultssupporting

confidence: 91%

Beneficial Effects of Nebivolol in Comparison with Atenolol on Safety and Tolerability in Essential Hypertension

Bhosale

2014

JCDR

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Section: Observations and Resultssupporting

confidence: 91%

Beneficial Effects of Nebivolol in Comparison with Atenolol on Safety and Tolerability in Essential Hypertension

Bhosale

2014

JCDR

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“…These results correlate to the study done by Van Bortel 13 with the exception that no significant changes in HDL cholesterol and TGs were observed in the respective study. However, our findings are in contrast with Pesant et al 20 and Badar et al 21 who showed in their studies that there was no change in lipid parameters in patients on treatment with nebivolol. Similarly, a study by Peter et al in patients of type 2 diabetes with mild to moderate hypertension exhibited no significant changes in serum cholesterol or TGs following treatment with nebivolol, but a significant increase in HDL cholesterol was noted.…”

Section: Discussioncontrasting

confidence: 99%

To study the comparative effects of nebivolol and metoprolol on lipid profile in patients of essential hypertension

Johar

Bhosle

Jaybhaye

et al. 2015

Int J Basic Clin Pharmacol

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INTRODUCTIONEssential or primary hypertension is the most prevalent type, affecting between 90% and 95% of patients diagnosed with hypertension.1 It has been reported to be the fourth contributor to premature death in developed countries and the seventh in developing countries.2 Recent reports indicate that nearly 1 billion adults (more than a quarter of the world's population) had hypertension in 2000, and this is predicted to increase to 1.56 billion by 2025.3 However, prevalence of hypertension in India, for the last three decades has increased by about 30 times among urban residents and by about 10 times among rural residents. 4 Hypertension and certain alteration in serum lipoproteins are complementary coronary risk factors. Several studies have indicated that high concentrations of low-density lipoprotein (LDL) cholesterol and triglyceride (TG) are strong risk factors for the development of cardiovascular disease (CVD). 5,6 It has been reported that the effect of antihypertensive agents on lipid metabolism exhibits a wide range. Some have adverse effect on the lipid profile whereas others have a neutral or favorable effect on it.7 Beta-adrenergic receptor antagonists (beta-blockers) are widely used for the management of CVDs and have been proved efficacious in the treatment of hypertension, coronary heart disease, including angina pectoris, myocardial infarction, and heart failure. Sixty patients of either sex in the age group of 30-65 years with blood pressure (BP) of ≥140/90 mmHg with deranged lipid parameters according to National Cholesterol Education Program were randomized into two groups. Group I received metoprolol (50 mg) and Group II received nebivolol (5 mg), both given once daily for 12 weeks. BP and lipid parameters were evaluated at baseline as well as at the end of 12 weeks. Results: There was significant reduction in BP values (p<0.0001) as compared to baseline in both the groups, however no significant difference was observed between two drugs revealing that their efficacy in reducing systolic BP/diastolic BP is comparable. Furthermore, both the drugs had a favorable effect on lipid profile, but more significant results on lipid profile were observed in the nebivolol group as compared to metoprolol group (p<0.0001). Conclusions: In our comparison study, it is seen that the favorable effect of nebivolol on serum lipids and its good tolerability profile make it a good choice for control of hypertension as well as preventing the long-term cardiovascular morbidities and mortalities.

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“…An insulin resistance index was also significantly reduced with nebivolol treatment, compared with metoprolol (P = 0.003), in hypertensive patients [46]. In other clinical trials, both atenolol and nebivolol had neutral effects on lipid or carbohydrate metabolism in normometabolic hypertensive patients [63], and nebivolol was associated with more favorable metabolic effects than atenolol in patients with hypertension and dyslipidemia, when pravastatin was added to both agents [64]. Nebivolol has also demonstrated neutral effects on carbohydrate metabolism and insulin sensitivity in patients with type 2 diabetes and hypertension [65].…”

Section: Nebivololmentioning

confidence: 80%

The vasodilatory beta-blockers

Pedersen¹,

Cockcroft

2007

Current Science Inc

122

102

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Although well established in treating hypertension and cardiovascular (CV) disease, clinical trial data suggest that beta-blockers (eg, atenolol) may be less effective than other antihypertensive classes in reducing stroke and CV mortality despite similar blood pressure (BP) reductions. One possible explanation is that atenolol is less effective in reducing central aortic pressure. Newer vasodilating beta-blockers may prove more effective in reducing central pressure and cardiovascular events. Carvedilol and labetalol appear to cause vasodilation through alpha(1)-receptor blockade; nebivolol induces endothelium-dependent vasodilation by stimulating nitric oxide bioactivity. Their favorable hemodynamic profile includes reduction of peripheral vascular resistance (PVR) while maintaining or improving cardiac output (CO), stroke volume, and left ventricular function, whereas nonvasodilating beta-blockers tend to raise PVR and reduce CO and left ventricular function. Compared with conventional beta-blockers, vasodilating beta-blockers have beneficial hemodynamic effects including decreased pressure wave reflection from the periphery, leading to decreases in central aortic blood pressure. Larger trials are needed to determine whether reduced central pressure will translate into improved CV outcomes compared with nonvasodilating beta-blockers.

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Metabolic and Antihypertensive Effects of Nebivolol and Atenolol in Normometabolic Patients with Mild-to-Moderate Hypertension

Cited by 27 publications

References 0 publications

Beneficial Effects of Nebivolol in Comparison with Atenolol on Safety and Tolerability in Essential Hypertension

Beneficial Effects of Nebivolol in Comparison with Atenolol on Safety and Tolerability in Essential Hypertension

To study the comparative effects of nebivolol and metoprolol on lipid profile in patients of essential hypertension

The vasodilatory beta-blockers

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