title: Singular and combined effects of nebivolol and lifestyle modification on large artery stiffness in hypertensive adults.
abstract: BACKGROUND
  We hypothesized that the combination of nebivolol and lifestyle modification would reduce large artery stiffness in middle-aged and older hypertensive adults more than either intervention alone.
  
  
  METHODS
  To address this, 45 men and women (age 40-75 years) with stage I hypertension were randomized to receive either nebivolol (NB; forced titration to 10 mg OD; n = 15; age 57.2 ± 11.4 years; body mass index [BMI] 30.8 ± 5.8 kg/m(2)), lifestyle modification (LM; 5-10% weight loss via calorie restriction and physical activity; n = 15; age 52.7 ± 8.5 years; BMI 33.9 ± 7.2 kg/m(2)) or nebivolol plus lifestyle modification (NBLM; n = 15; age 58.9 ± 9.4 years; BMI 32.5 ± 4.9 kg/m(2)) for 12 weeks. β-stiffness index, a blood-pressure-independent measure of arterial stiffness, and arterial compliance were measured via high-resolution ultrasound and tonometry at baseline and after the 12-week intervention. There was no difference between groups in age, body weight or composition, blood pressure, or in β-stiffness index or arterial compliance at baseline (all p > 0.05).
  
  
  RESULTS
  Following the 12-week intervention, body weight decreased ~5% (p < 0.05) in the LM and NBLM groups but did not change from baseline in the NB group (p > 0.05). Supine brachial and carotid systolic and diastolic blood pressure declined following treatment in each of the groups (p < 0.05). However, the magnitude of reduction was not different (p < 0.05) between groups. β-stiffness index declined (-2.03 ± 0.60, -1.87 ± 0.83 and -2.51 ± 0.90 U) and arterial compliance increased similarly (both p > 0.05) in the NB, LM and NBLM groups, respectively.
  
  
  CONCLUSIONS
  In summary, our findings indicate that the combination of nebivolol and lifestyle modification reduced large artery stiffness to a similar degree as either intervention alone in middle-aged and older hypertensive adults.
authors.affiliation: Human Integrative Physiology Laboratory, Fralin Translational Obesity Research Center, Department of Human Nutrition, Foods and Exercise, Virginia Polytechnic Institute and State University, Blacksburg, VA 24061, USA.
authors.forename: Timothy J
authors.initials: TJ
authors.lastname: Werner
authors.forename: Nabil E
authors.initials: NE
authors.lastname: Boutagy
authors.forename: Kristin L
authors.initials: KL
authors.lastname: Osterberg
authors.forename: Jose M
authors.initials: JM
authors.lastname: Rivero
authors.forename: Kevin P
authors.initials: KP
authors.lastname: Davy
mesh_terms: D058671:Adrenergic beta-1 Receptor Antagonists / Q000627:therapeutic use*; D000328:Adult; D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D062186:Arterial Pressure / Q000187:drug effects; D001578:Benzopyrans / Q000627:therapeutic use*; D031204:Caloric Restriction; D003131:Combined Modality Therapy; D004983:Ethanolamines / Q000627:therapeutic use*; D015444:Exercise; D005260:Female; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D000068577:Nebivolol; D040242:Risk Reduction Behavior; D013997:Time Factors; D016896:Treatment Outcome; D059289:Vascular Stiffness / Q000187:drug effects*; D014665:Vasodilator Agents / Q000627:therapeutic use*; D014768:Virginia; D015431:Weight Loss
chemical_list: D058671:Adrenergic beta-1 Receptor Antagonists; D000959:Antihypertensive Agents; D001578:Benzopyrans; D004983:Ethanolamines; D014665:Vasodilator Agents; D000068577:Nebivolol
keywords: antihypertensive; arterial distensibility; beta-blocker