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

Abstract

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.

Hypertension‐induced subclinical vascular and cognitive changes are reversible—An observational cohort study

“…As hypertension is the strongest modifiable risk factor directly leading to arterial stiffness, a number of clinical trials have been carried out in the past to investigate the effect of antihypertensive medications on the change in arterial stiffness. Almost all classes of the tested antihypertensive medications effectively decreased arterial stiffness . In our study group, both stiffness parameters (PWV and AIx) decreased upon antihypertensive treatment; however, the reduction was statistically not significant.…”

Probiotic supplementation and trimethylamine‐N‐oxide production following a high‐fat diet

“…Body mass was measured on a digital scale (Model 5002, Scale-Tronix, Inc.) and height was measured using a stadiometer. Brachial arterial pressure was measured in a seated position using automated sphygmomanometry (Pilot model 9200, Colin Instruments Corp.) (21). Habitual dietary intake was assessed using detailed 4-day diet records.…”

“…Central and peripheral arterial pressures were obtained using a highfidelity, non-invasive applanation tonometer and a semi-automated computed controlled device (NIHem, Cardiovascular Engineering) as previously described (21,25). b-stiffness index, a relatively blood pressure independent index of carotid artery stiffness, was measured using an ultrasound unit (Sonos 7500, Phillips Medical Systems) equipped with a high-resolution linear array transducer (3)(4)(5)(6)(7)(8)(9)(10)(11) and applanation tonometry (NIHem, Cardiovascular Engineering) as previously described (21).…”

A Review of Nebivolol Pharmacology and Clinical Evidence

“…A few more recent publications also provided evidence of improvement in central hemodynamics with nebivolol. For example, in a trial that randomized 45 patients with stage I hypertension to nebivolol (10 mg/day), lifestyle modifications, or the combination of nebivolol and lifestyle modifications for 12 weeks, the β-stiffness index, a blood-pressure-independent measure of arterial stiffness, decreased ( p < 0.01), and arterial compliance increased ( p = 0.02) [ 31 ]. Another trial randomized 138 patients with mild to moderate hypertension to atenolol (50–100 mg/day) or nebivolol (5 mg/day) for 10 weeks, with hydrochlorothiazide 25 mg/day added on if necessary to control blood pressure.…”