Integrated effects of the vasodilating beta-blocker nebivolol on exercise performance, energy metabolism, cardiovascular and neurohormonal parameters in physically active patients with arterial hypertension.
OBJECTIVE
The present study was designed to investigate the integrated effects of the beta-1-selective blocker with vasodilator properties, nebivolol, on systemic haemodynamics, neurohormones and energy metabolism as well as oxygen uptake and exercise performance in physically active patients with moderate essential hypertension (EH).


METHODS
Eighteen physically active patients with moderate EH were included: age: 46.9 +/- 2.38 years, weight: 83.9 +/- 2.81 kg, blood pressure (BP): 155.8 +/- 3.90/102.5 +/- 1.86 mm Hg, heart rate: 73.6 +/- 2.98 min(-1). After a 14-day wash-out period a bicycle spiroergometry until exhaustion (WHO) was performed followed by a 45-min submaximal exercise test on the 2.5 mmol/l lactate-level 48 h later. Before, during and directly after exercise testing blood samples were taken. An identical protocol was repeated after a 6-week treatment period with 5 mg nebivolol/day.


RESULTS
Nebivolol treatment resulted in a significant (P < 0.01) decrease in systolic and diastolic BP and heart rate at rest and during maximal and submaximal exercise. Maximal physical work performance, blood lactate and rel. oxygen uptake (rel. VO(2)) before and after nebivolol treatment at rest and during maximal and submaximal exercise remained unaltered. Free fatty acid, free glycerol, plasma catecholamines, beta-endorphines and atrial natriuretic peptide (ANP) increased before and after treatment during maximal and submaximal exercise but remained unaltered by nebivolol treatment. In contrast, plasma ANP levels at rest were significantly higher in the presence of nebivolol, endothelin-1 levels were unchanged.


CONCLUSIONS
Nebivolol was effective in the control of BP at rest and during exercise in patients with EH. Furthermore, nebivolol did not negatively affect lipid and carbohydrate metabolism and substrate flow. The explanation for the effects on ANP at rest remain elusive. This pharmacodynamic profile of nebivolol is potentially suitable in physically active patients with EH.
Predel
H G
HG
Institute of Cardiology and Sports Medicine, German Sports University, Cologne, Germany. Predel@hrz.dshs_koeln.de
Mainka
W
W
Schillings
W
W
Knigge
H
H
Montiel
J
J
Fallois
J
J
Agrawal
R
R
Schramm
T
T
Graf
C
C
Giannetti
B M
BM
Bjarnason-Wehrens
B
B
Prinz
U
U
Rost
R E
RE
D000319:Adrenergic beta-Antagonists / Q000097:blood / Q000494:pharmacology*; D000328:Adult; D000704:Analysis of Variance; D001578:Benzopyrans / Q000097:blood / Q000494:pharmacology*; D001786:Blood Glucose / Q000032:analysis; D002395:Catecholamines / Q000097:blood; D002851:Chromatography, High Pressure Liquid; D004734:Energy Metabolism / Q000187:drug effects*; D004983:Ethanolamines / Q000097:blood / Q000494:pharmacology*; D005080:Exercise Test / Q000187:drug effects; D006439:Hemodynamics / Q000187:drug effects*; D019382:Human Growth Hormone / Q000097:blood; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D006973:Hypertension / Q000097:blood*; D007124:Immunoenzyme Techniques; D007328:Insulin / Q000097:blood; D019344:Lactic Acid / Q000097:blood; D008055:Lipids / Q000097:blood; D008875:Middle Aged; D000068577:Nebivolol; D009490:Neurosecretory Systems / Q000187:drug effects*; D005082:Physical Exertion / Q000187:drug effects*; D010809:Physical Fitness; D010865:Pilot Projects; D011863:Radioimmunoassay; D014665:Vasodilator Agents / Q000097:blood / Q000494:pharmacology*; D001615:beta-Endorphin / Q000097:blood
D000319:Adrenergic beta-Antagonists; D001578:Benzopyrans; D001786:Blood Glucose; D002395:Catecholamines; D004983:Ethanolamines; D007328:Insulin; D008055:Lipids; D014665:Vasodilator Agents; D000068577:Nebivolol; D019382:Human Growth Hormone; D019344:Lactic Acid; D001615:beta-Endorphin; D006854:Hydrocortisone