Nebivolol in high-risk, obese African Americans with stage 1 hypertension: effects on blood pressure, vascular compliance, and endothelial function.
The authors sought to determine whether nebivolol treatment results in changes in blood pressure (BP), nitric oxide bioavailability, and vascular function in obese African Americans with recently diagnosed stage 1 hypertension. Forty-three obese, hypertensive African Americans (mean BP: systolic, 148.8+/-14.3 mm Hg; diastolic, 90.4+/-8.2 mm Hg) were treated with nebivolol (5-10 mg/d) for 8 weeks. Primary outcomes were change in systolic and diastolic BP and efficacy in reaching normotensive BP. Mean systolic BP decreased by 9.2+/-14 mm Hg (P<.005) and diastolic BP decreased 6.8+/-9 mm Hg (P<.005) with 8 weeks of therapy. Significant improvements were seen in arterial compliance with nebivolol treatment as measured by aortic augmentation index (P<.005) and time to wave reflection (P=.013). Nebivolol treatment improved endothelial function as measured by flow-mediated dilation (P<.005). Levels of erythrocyte cellular superoxide dismutase increased with nebivolol, indirectly suggesting increased bioavailability of nitric oxide (P<.005). Monotherapy with nebivolol in obese, hypertensive African Americans results in significant systolic and diastolic BP reduction by mechanisms that include improved vascular function and compliance.
Merchant
Nadya
N
Department of Cardiology, Emory University, 69 Jesse Hill Drive SE, Atlanta, GA30303, USA.
Searles
Charles D
CD
Pandian
Anbu
A
Rahman
Syed T
ST
Ferdinand
Keith C
KC
Umpierrez
Guillermo E
GE
Khan
Bobby V
BV
D000293:Adolescent; D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data*; D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001262:Atenolol / Q000627:therapeutic use; D001578:Benzopyrans / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects; D003187:Compliance / Q000187:drug effects; D003971:Diastole / Q000187:drug effects; D004730:Endothelium, Vascular / Q000187:drug effects; D004983:Ethanolamines / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000188:drug therapy* / Q000208:ethnology; D008297:Male; D008875:Middle Aged; D000068577:Nebivolol; D009569:Nitric Oxide; D009765:Obesity / Q000150:complications*; D011446:Prospective Studies; D012039:Regional Blood Flow / Q000187:drug effects; D018570:Risk Assessment; D012307:Risk Factors; D013599:Systole / Q000187:drug effects; D014481:United States / Q000453:epidemiology; D014664:Vasodilation / Q000187:drug effects; D014665:Vasodilator Agents / Q000627:therapeutic use; D055815:Young Adult
D000319:Adrenergic beta-Antagonists; D000959:Antihypertensive Agents; D001578:Benzopyrans; D004983:Ethanolamines; D014665:Vasodilator Agents; D000068577:Nebivolol; D009569:Nitric Oxide; D001262:Atenolol