Comparative effects of nebivolol and metoprolol on oxidative stress, insulin resistance, plasma adiponectin and soluble P-selectin levels in hypertensive patients.
OBJECTIVE
To determine the effects of nebivolol on oxidative stress, insulin resistance, adiponectin and plasma soluble P-selectin levels in hypertensive patients in comparison with metoprolol.


METHODS
Eighty newly diagnosed hypertensive patients in grade 1 hypertension according to the European Society of Hypertension and European Society of Cardiology guidelines were enrolled in this prospective, blinded, randomized study. Seventy-two patients completed the study. After baseline assessment, each patient was randomly allocated to a 5 mg daily dose of nebivolol (n = 37, 20 male) or a 100 mg daily dose of metoprolol (n = 35, 18 male) and treated for 6 months. Blood pressure, heart rate, oxidative stress (malonyldialdehyde), homeostasis model assessment: insulin resistance, adiponectin and plasma soluble P-selectin levels were measured before and after treatment.


RESULTS
At the end of treatment, nebivolol and metoprolol significantly decreased blood pressure and heart rate, with a more pronounced bradycardic effect of metoprolol. Nebivolol, but not metoprolol, significantly lowered oxidative stress (P = 0.03), the insulin resistance index (P = 0.003) and plasma soluble P-selectin levels (P = 0.008), and increased adiponectin levels (P = 0.04).


CONCLUSIONS
Nebivolol, in contrast to metoprolol, improved oxidative stress, insulin sensitivity, decreased plasma soluble P-selectin and increased adiponectin levels in hypertensive patients. These beneficial effects of nebivolol may contribute to a reduction in cardiovascular risk in hypertensive patients.
Department of Cardiology, Gulhane Military Medical Academy, Etlik, Ankara, Turkey. benturgay@yahoo.com
Turgay
T
Celik
Atila
A
Iyisoy
Hurkan
H
Kursaklioglu
Ejder
E
Kardesoglu
Selim
S
Kilic
Hasan
H
Turhan
M Ilker
MI
Yilmaz
Omer
O
Ozcan
Halil
H
Yaman
Ersoy
E
Isik
Francesco
F
Fici
D052242:Adiponectin / Q000097:blood; D000328:Adult; D000959:Antihypertensive Agents / Q000494:pharmacology / Q000627:therapeutic use; D001578:Benzopyrans / Q000494:pharmacology* / Q000627:therapeutic use; D004983:Ethanolamines / Q000494:pharmacology* / Q000627:therapeutic use; D005260:Female; D006801:Humans; D006973:Hypertension / Q000097:blood / Q000188:drug therapy*; D007333:Insulin Resistance; D008297:Male; D008790:Metoprolol / Q000494:pharmacology* / Q000627:therapeutic use; D008875:Middle Aged; D000068577:Nebivolol; D018384:Oxidative Stress / Q000187:drug effects*; D019007:P-Selectin / Q000097:blood / Q000187:drug effects; D011446:Prospective Studies; D016037:Single-Blind Method
D052242:Adiponectin; D000959:Antihypertensive Agents; D001578:Benzopyrans; D004983:Ethanolamines; D019007:P-Selectin; D000068577:Nebivolol; D008790:Metoprolol