title: Central hemodynamics in prehypertension: effect of the β-adrenergic antagonist nebivolol.
abstract: The aim of the current study was to characterize the effects of the novel β-adrenergic antagonist nebivolol on central aortic blood pressures, arterial properties, and nitroxidergic activity in individuals with prehypertension. Prehypertension is emerging as a major risk factor for several adverse cardiovascular consequences. Increased pulse wave velocity, aortic augmentation index, and aortic blood pressures have been linked with augmented risk of cardiovascular disease and mortality. While the effects of antihypertensive drugs on these parameters in hypertensive patients have been studied, there are limited data so far in prehypertension. Fifty individuals with prehypertension were randomized to either nebivolol (5 mg per day) or placebo in a double-blind clinical trial. Patients underwent measurement of pulse wave velocity as well as aortic blood pressure and aortic augmentation index via pulse wave analysis at baseline and 8 weeks. Patients also had blood and urine biochemistries done at each visit. Nebivolol achieved significant reductions in central aortic systolic (P=.011), diastolic (P=.009), and mean arterial blood pressure (P=.002). Pulse wave velocity trended toward improvement but did not achieve significance (P=.088). Nitric oxide production, measured as urinary nitrite/nitrite excretion, also rose substantially in the nebivolol group (by approximately 60%, P=.030). Central blood pressures can be effectively lowered by β-blockade while patients are still in the prehypertension phase, and the effects may be coupled to improve nitric oxide release by the drug.
authors.affiliation: Department of Medicine, VA San Diego Healthcare System and the University of California, San Diego, CA 92093, USA. jasontdavis18@gmail.com
authors.forename: Jason T
authors.initials: JT
authors.lastname: Davis
authors.forename: Dalal N
authors.initials: DN
authors.lastname: Pasha
authors.forename: Srikrishna
authors.initials: S
authors.lastname: Khandrika
authors.forename: Maple M
authors.initials: MM
authors.lastname: Fung
authors.forename: Milos
authors.initials: M
authors.lastname: Milic
authors.forename: Daniel T
authors.initials: DT
authors.lastname: O'Connor
mesh_terms: D000293:Adolescent; D058671:Adrenergic beta-1 Receptor Antagonists / Q000627:therapeutic use*; D000328:Adult; D001578:Benzopyrans / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects*; D016009:Chi-Square Distribution; D004311:Double-Blind Method; D004797:Enzyme-Linked Immunosorbent Assay; D004983:Ethanolamines / Q000627:therapeutic use*; D005260:Female; D006439:Hemodynamics / Q000187:drug effects*; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D000068577:Nebivolol; D010919:Placebos; D018709:Statistics, Nonparametric; D016896:Treatment Outcome
chemical_list: D058671:Adrenergic beta-1 Receptor Antagonists; D001578:Benzopyrans; D004983:Ethanolamines; D010919:Placebos; D000068577:Nebivolol