The Effect of Different β-Blockers on Vascular Graft Nitric Oxide Levels: Comparison of Nebivolol Versus Metoprolol

Bayar, Ekrem; İlhan, Gökhan; Furat, Cevdet; Atık, Cem; Arslanoğlu, Yavuz; Kuran, C.; Özpak, Berkan; Durakoğlugil, Murtaza Emre

doi:10.1016/j.ejvs.2013.11.003

Cited by 11 publications

(9 citation statements)

References 20 publications

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“…Therefore, the improved effect of nifedipine and methyldopa on NO production may be responsible for the increased number of EPCs in the peripheral blood. No significant effect of metoprolol on NO production was observed; however, it protected and promoted EPC proliferation under ischaemia/reperfusion conditions . Under conditions of oxidative stress and excessive inflammation, implicated in pregnancy‐induced hypertension, EPCs are prone to premature death, which plausibly decreased their total number in the peripheral blood.…”

Section: Discussionmentioning

confidence: 78%

Effects of metoprolol, methyldopa, and nifedipine on endothelial progenitor cells in patients with gestational hypertension and preeclampsia

Yan-gui

Liu

et al. 2019

Clin Exp Pharma Physio

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Hypertension is the most common pathological symptom during pregnancy, occurring in approximately 10% of all pregnancies. 1 As suggested by the American College of Obstetricians and Gynaecologists (ACOG), hypertensive disorders of pregnancy (HDPs) are classified into five categories: (a) chronic hypertension, (b) gestational hypertension, (c) preeclampsia, (d) eclampsia, and (e) preeclampsia superimposed on chronic hypertension. 1,2 Statistically, HDPs feature among the top six causes of maternal mortality in the United States Summary Endothelial progenitor cells (EPCs) are critical for vascular regeneration and function, but are reduced in hypertensive disorders of pregnancy. We aimed to determine the possible effects of antihypertensive drugs, such as metoprolol, methyldopa, and nifedipine, on EPC number and functions in patients with gestational hypertension and preeclampsia. We collected blood samples from 30 normal pregnant women, 67 patients with gestational hypertension and 48 patients with preeclampsia. The patients received no drug or an antihypertensive drug, such as metoprolol, methyldopa, or nifedipine, between 20 and 24 weeks of gestation. The number of EPCs and circulating endothelial cells (CECs) in the blood was measured by flow cytometry. Moreover, colony formation and migration assays were performed on the isolated EPCs. Both the systolic and diastolic blood pressure (BP) increased, while the percentage of flow-mediated vasodilatation (FMD) decreased in patients with gestational hypertension and preeclampsia, compared to the healthy controls at 20 weeks of gestation. CEC number increased in the patients, whereas EPC counts decreased.Furthermore, EPC colony formation and migration abilities were also impaired in the patients. However, administration of metoprolol, methyldopa, or nifedipine effectively restored the systolic and diastolic BP, FMD%, EPCs, and CEC numbers, as well as EPC migration capacity. Endothelial progenitor cells colony formation ability selectively improved with methyldopa and nifedipine. In patients receiving no drugs, most of these indexes worsened within 4 weeks (study duration). This study revealed a new pharmacological action of these antihypertensive drugs against gestational hypertension and preeclampsia, thus supporting their clinical use. K E Y W O R D Santihypertensive drugs, endothelial progenitor cells, gestational hypertension, preeclampsia

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Section: Discussionmentioning

confidence: 78%

Effects of metoprolol, methyldopa, and nifedipine on endothelial progenitor cells in patients with gestational hypertension and preeclampsia

Yan-gui

Liu

et al. 2019

Clin Exp Pharma Physio

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“…Greater NO activity was found in internal mammary artery and vein specimens from patients pretreated with nebivolol compared with metoprolol . In patients with coronary artery disease or hypertension, nebivolol but not atenolol improved flow‐mediated dilation and lowered asymmetric dimethylarginine levels, a naturally occurring amino acid that inhibits endothelial NO synthase .…”

Section: Discussionmentioning

confidence: 98%

Nitric Oxide Contributes to Vasomotor Tone in Hypertensive African Americans Treated With Nebivolol and Metoprolol

Neuman

Hayek

Poole

et al. 2015

J of Clinical Hypertension

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Endothelial dysfunction is more prevalent in African Americans (AA) compared to whites. We hypothesized that nebivolol, a selective β-1 antagonist that stimulates NO, will improve endothelial function in AA with hypertension when compared to metoprolol. In a double-blind, randomized, cross-over study, 19 AA hypertensive subjects were randomized to a 12-week treatment period with either nebivolol 10mg or metoprolol succinate 100mg daily. Forearm blood flow (FBF) was measured using plethysmography at rest and after intra-arterial infusion of acetylcholine, and sodium nitroprusside to estimate endothelium-dependent and independent vasodilation, respectively. Physiologic vasodilation was assessed during hand-grip exercise. Measurements were repeated after NO blockade with L-NG-monomethylarginine (L-NMMA), and after inhibition of endothelium-derived hyperpolarizing factor (EDHF) with tetraethylammonium chloride (TEA). NO blockade with L-NMMA produced a trend toward greater vasoconstriction during nebivolol compared to metoprolol treatment period (21% vs 12% reduction in FBF, p=0.06, respectively). This difference was more significant after combined administration of L-NMMA and TEA (p<0.001). Similarly, there was a contribution of NO to exercise-induced vasodilation during nebivolol but not during metoprolol treatment. There were significantly greater contributions of NO and EDHF to resting vasodilator tone and of NO to exercise-induced vasodilation with nebivolol compared to metoprolol in AA with hypertension.

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“…Sarikaya and colleagues 15 suggest that nebivolol might be considered a good choice in hypertensive patients undergoing cardiac surgery, given its prevention of perioperative myocardial hypoperfusion, which increases early morbidity and mortality. Bayar and colleagues 16 suggest that nebivolol may be safer and preferable to diminish graft spasm in patients undergoing CABG surgery because of the NO-mediated vasodilation effect. 16 Vasorelaxant beta-blockers used post-CABG may have beneficial effects on postsurgical problems (graft occlusion and vasospasm) and the short-, mid-, and long-term patency rates of RA grafts.…”

Section: Discussionmentioning

confidence: 99%

“…Bayar and colleagues 16 suggest that nebivolol may be safer and preferable to diminish graft spasm in patients undergoing CABG surgery because of the NO-mediated vasodilation effect. 16 Vasorelaxant beta-blockers used post-CABG may have beneficial effects on postsurgical problems (graft occlusion and vasospasm) and the short-, mid-, and long-term patency rates of RA grafts.…”

Section: Discussionmentioning

confidence: 99%

Labetalol, nebivolol, and propranolol relax human radial artery used as coronary bypass graft

Korkmaz

Saraç

Göksel

et al. 2015

The Journal of Thoracic and Cardiovascular Surgery

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We speculated that the relaxant effect of labetalol, nebivolol, and propranolol was due partly to the Ca(2+)-activated K(+) channels. In addition, the relaxation induced by nebivolol was largely related with nitric oxide release. Nebivolol, and partly propranolol, may provide significant therapeutic benefit, but labetalol can be a good alternative for coronary artery bypass grafting with radial artery use.

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The Effect of Different β-Blockers on Vascular Graft Nitric Oxide Levels: Comparison of Nebivolol Versus Metoprolol

Abstract: According to our results, we think that nebivolol may be safer and preferable in order to diminish graft spasm in patients undergoing coronary artery bypass graft surgery due to the NO-mediated vasodilating effect.

Cited by 11 publications

References 20 publications

Effects of metoprolol, methyldopa, and nifedipine on endothelial progenitor cells in patients with gestational hypertension and preeclampsia

Effects of metoprolol, methyldopa, and nifedipine on endothelial progenitor cells in patients with gestational hypertension and preeclampsia

Nitric Oxide Contributes to Vasomotor Tone in Hypertensive African Americans Treated With Nebivolol and Metoprolol

Labetalol, nebivolol, and propranolol relax human radial artery used as coronary bypass graft

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