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

Year : 2012  |  Volume : 44  |  Issue : 3  |  Page : 407-411

Indian J Pharmacol. Radhika Soanker1, M.U.R Naidu1, Sree Bhushan Raju2, A Krishna Prasad3, T Ramesh Kumar Rao1 1 Department of Clinical Pharmacology and Therapeutics, Nizams Institute of Medical Sciences, Hyderabad, India 2 Department of Nephrology, Nizams Institute of Medical Sciences, Hyderabad, India 3 Department of General Medicine, Nizams Institute of Medical Sciences, Hyderabad, India

Introduction

Blood pressure (BP) reduction is the major determinant of benefit provided by antihypertensive treatment. Although different drugs reduce peripheral BP to some extent, there may be a significant difference in their effect on central BP reduction. It has been shown that beta-blockers are efficient in reducing peripheral, but not central BP. This study was done to assess the effect of beta-1-blocker, nebivolol, in patients with essential hypertension on central aortic pressures and arterial stiffness.

Materials and Methods

In this single arm, open-labeled study, 13 patients were given nebivolol, 5 mg orally once daily for 15 days. Primary outcome was change in central aortic pressure, and other measures of efficacy included changes in brachial BP, augmentation index (AIx%), AIx%@75 HR, augmentation pressure (AP), heart rate (HR), and carotid femoral pulse wave velocity (PWVcf).

Results

Nebivolol 5 mg significantly reduced central aortic pressures [systolic BP, 131.5-111.6 mmHg; diastolic BP, 96.3-81.7 mmHg; Mean Arterial Pressure (MAP), 111.3-94.0 mmHg (all P<0.0001), and Pulse Pressure (PP), 35.2-29.7 mmHg (P<0.01)]. AIx%@75 HR reduced from 29 to 21.6 (P<0.001) and PWVcf reduced from 8.6 to 7.2 m/s (P<0.001). One subject was lost to followup.

Conclusion 

Nebivolol 5 mg demonstrated antihypertensive efficacy in patients with essential hypertension by reducing not only peripheral brachial pressures, but also significantly reducing central aortic pressures, augmentation index, and carotid femoral pulse wave velocity, which is the marker of arterial stiffness.

Keywords: Nebivolol, central aortic pressures, arterial stiffness

*In Pakistan, it is marketed by Searle Pakistan Limited as Byscard.