Effect of beta-1-blocker, nebivolol, on central aortic pressure and arterial stiffness in patients with essential hypertension
Indian J Pharmacol. Year : 2012  |  Volume : 44  |  Issue : 3  |  Page : 407-411

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, 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.

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

The Treatment of Hypertensive Asthmatic Subjects with Highly Selective β blocker - Nebivolol

Abstract 

Rationale

The benefit from using selective β blockers due to arterial hypertension and ischemic heart disease is well known. Asthmatic subjects are the special “group of risk” with relative contraindications for this therapy. The novel highly selective β-blocker nebivolol which additionally posses vasodilatatory effect through nitric oxide release is potentially safe in asthma.

Methods

The aim of the study was to evaluate the influence of one dose 5 mg of nebivolol orally administrated compared with placebo to spirometric parameters and blood pressure. The study was performed double-blind cross–over method in patient with mild/moderate persistent asthma. The patients were treated with nebivolol or placebo with 7 days of “wash–out”. The spirometry was done at 0, 2 h, 6h and 24 h after administration. Blood pressure was measured continuously through 24 hours.

Results

None of the patient reacted with dyspnoe or with significant fall of FEV₁. In all cases a moderate but significant decrease of blood pressure was observed.

Conclusions

Nebivolol seems to be a safe and effective in treatment asthmatic hypertensive patients.

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