title: Differential Metabolic Effects of Beta-Blockers: an Updated Systematic Review of Nebivolol.
abstract: Blood pressure management in hypertensive patients with metabolic abnormalities is challenging, since many of the antihypertensive drugs adversely affect metabolism. Besides effective control of blood pressure in patients with hypertension, third-generation beta-blockers such as nebivolol offer additional benefits for central hemodynamics and neutral or beneficial effects on metabolism. Emerging clinical data suggest that nebivolol also has similar effects on metabolism in obese hypertensive and hypertensive diabetic patients. The present article will provide a systematic analysis of the pathophysiological links among hypertension, insulin resistance, and metabolic syndrome. We will also summarize the available clinical evidence regarding the metabolic effects of beta-blockers in hypertensive patients, with an emphasis on nebivolol. Nebivolol exerts neutral or beneficial effects on insulin sensitivity and lipid metabolism in hypertensive patients, owing to its nitric oxide-mediated vasodilatory and antioxidative properties. Thus, nebivolol could be a favorable therapeutic option for the treatment of hypertension in patients with impaired glucose and lipid metabolism.
authors.affiliation: Cardiology Department, Heraklion University Hospital, P.O. Box 1352, Stavrakia, Heraklion, Crete, Greece.
authors.forename: Maria
authors.initials: M
authors.lastname: Marketou
authors.affiliation: SPRIM Asia-Pacific Pvt. Ltd., Singapore, Singapore.
authors.forename: Yashaswi
authors.initials: Y
authors.lastname: Gupta
authors.affiliation: SPRIM Asia-Pacific Pvt. Ltd., Singapore, Singapore.
authors.forename: Shashank
authors.initials: S
authors.lastname: Jain
authors.affiliation: Cardiology Department, Heraklion University Hospital, P.O. Box 1352, Stavrakia, Heraklion, Crete, Greece. cardio@med.uoc.gr.
authors.forename: Panos
authors.initials: P
authors.lastname: Vardas
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use*; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects*; D003920:Diabetes Mellitus / Q000188:drug therapy; D004983:Ethanolamines / Q000494:pharmacology; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D007333:Insulin Resistance; D024821:Metabolic Syndrome / Q000188:drug therapy*; D000068577:Nebivolol / Q000627:therapeutic use*; D009569:Nitric Oxide / Q000378:metabolism
chemical_list: D000319:Adrenergic beta-Antagonists; D000959:Antihypertensive Agents; D004983:Ethanolamines; D000068577:Nebivolol; D009569:Nitric Oxide
keywords: Hypertension; Insulin sensitivity; Lipid metabolism; Nebivolol; Obesity