scholarly journals The role of nebivolol in the management of hypertensive patients: from pharmacological profile to treatment guidelines

2021 ◽  
Author(s):  
Claudio Ferri
Keyword(s):  
Treatment Guidelines ◽  
Metabolic Effects ◽  
Third Generation ◽  
Pharmacological Profile ◽  
Good Tolerability ◽  
Hypertensive Patients ◽  
Β Blocker ◽  
Β Blockers ◽  
Treatment Step

According to the most recent international guidelines, β-blockers maintain a central role in the management of hypertension, being recommended at any treatment step when there is a specific indication, such as heart failure, angina, postacute myocardial infarction, atrial fibrillation or pregnancy. However, β-blockers are not a homogeneous class: individual molecules differ in terms of pharmacological and clinical profile and are therefore suitable for different patient subtypes. In particular nebivolol, a third generation β1-selective β-blocker with vasodilating properties, neutral metabolic effects and good tolerability, proved to have advantages over other β-blockers, which makes the drug suitable in a wide variety of hypertensive patients with or without comorbidities.

Beta-adrenoblockers of third generation as medicines for drug therapy of patients with chronic kidney disease

2016 ◽  
Vol 14 (2) ◽  
pp. 58-64
Author(s):  
Oleg B Kuzmin ◽  
Vladislav V Zhezha ◽  
Vitaly V Belyanin ◽  
Natalya V Buchneva
Keyword(s):  
Chronic Kidney Disease ◽  
Clinical Trials ◽  
Diabetic Nephropathy ◽  
Drug Therapy ◽  
Kidney Disease ◽  
Third Generation ◽  
Hypertensive Patients ◽  
Β Blockers

The review discusses the results of preclinical and clinical trials on the identification of nephroprotective action of β-blockers 3 generation carvedilol and nebivolol on models of hypertensive and diabetic nephropathy and patients with chronic kidney disease. It was concluded that nebivolol and especially carvedilol differs from its predecessors additional antioxidant and nephroprotective properties may be the drugs of choice from β-blockers for drug therapy of hypertensive patients with chronic kidney disease.

scholarly journals Chronotropic Incompentence and Functional Capacity in Chronic Heart Failure: No Role of β-Blockers and β-Blocker Dose

2010 ◽  
Vol 30 (2) ◽  
pp. 100-108 ◽  
Author(s):  
Damiano Magrì ◽  
Pietro Palermo ◽  
Filippo M. Cauti ◽  
Mauro Contini ◽  
Stefania Farina ◽  
...  
Keyword(s):  
Heart Failure ◽  
Chronic Heart Failure ◽  
Functional Capacity ◽  
Β Blocker ◽  
Β Blockers

Treatment of Hypertensive Patients with Ventricular Arrhythmias: Comparison and Combination of β-Blocker and Anti-Arrhythmic Therapy

1989 ◽  
Vol 17 (2) ◽  
pp. 113-124
Author(s):  
S. Di Somma ◽  
S. Savonitto ◽  
M. Petitto ◽  
V. Liguori ◽  
C. Magnotta ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Ventricular Arrhythmias ◽  
Good Effect ◽  
Atrial Arrhythmias ◽  
Once Daily ◽  
Hypertensive Patients ◽  
Effect Of Therapy ◽  
Β Blocker ◽  
Β Blockers ◽  
Exercise Induced

The effect of therapy with atenolol and tocainide, separately or in combination, was studied in 20 patients with hypertension and concomitant ventricular arrhythmias. Patients were given 400 mg tocainide, three times daily, 100 mg atenolol, once daily (plus 25 mg hydrochlorothiazide and 2.5 mg amiloride diuretics if required) and a combination of these treatments. Tocainide alone significantly reduced the incidence of ventricular arrhythmias without affecting atrial arrhythmias. It also controlled exercise-induced arrhythmias in 7/13 (54%) patients. Atenolol significantly reduced atrial arrhythmias and had a good effect on exercise-induced arrhythmias (reduced in 75% of patients), but it did not have a significant effect on ventricular arrhythmias. In 13 patients, despite normalization of blood pressure by atenolol, it was necessary to combine antihypertensive therapy (atenolol) with anti-arrhythmic therapy (tocainide) in order to reduce ventricular arrhythmias. All drugs were well tolerated. It is concluded that, in certain patients, specific anti-arrhythmic treatment may be necessary to control ventricular arrhythmias in hypertensive patients despite normalization of blood pressure by β-blockers.

The role of β-blockers in patients with metabolic syndrome and hypertension

2015 ◽  
Vol 156 (16) ◽  
pp. 623-625 ◽  
Author(s):  
Csaba András Dézsi
Keyword(s):  
Diabetes Mellitus ◽  
Metabolic Syndrome ◽  
Ventricular Dysfunction ◽  
Combined Treatment ◽  
Left Ventricular ◽  
Cardiac Insufficiency ◽  
Choice Of Treatment ◽  
Β Blocker ◽  
Β Blockers

The choice of treatment of patients with hypertension should not be based solely on the blood pressure value, because the risk of cardiovascular diseases are influenced by the presence and magnitude of other risk factors, too. The presence of a metabolic disease (diabetes mellitus, metabolic syndrome) itself categorizes the patient as a high risk individual. In such cases the use of combined treatment is usually considered. For example, in case of hypertension aggraviated by left ventricular dysfunction, ischaemic heart disease or cardiac insufficiency, β-blocker treatment is usually included in the combination of the first setting. Orv. Hetil., 2015, 156(16), 623–625.

scholarly journals Comprehensive Comparative Effectiveness and Safety of First-Line β-Blocker Monotherapy in Hypertensive Patients

Hypertension ◽  
2021 ◽  
Vol 77 (5) ◽  
pp. 1528-1538
Author(s):  
Seng Chan You ◽  
Harlan M. Krumholz ◽  
Marc A. Suchard ◽  
Martijn J. Schuemie ◽  
George Hripcsak ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Acute Myocardial Infarction ◽  
Comparative Effectiveness ◽  
Third Generation ◽  
First Line ◽  
The Third ◽  
Empirical Calibration ◽  
Β Blocker ◽  
Β Blockers

Evidence for the effectiveness and safety of the third-generation β-blockers other than atenolol in hypertension remains scarce. We assessed the effectiveness and safety of β-blockers as first-line treatment for hypertension using 3 databases in the United States: 2 administrative claims databases and 1 electronic health record–based database from 2001 to 2018. In each database, comparative effectiveness of β-blockers for the risks of acute myocardial infarction, stroke, and hospitalization for heart failure was assessed, using large-scale propensity adjustment and empirical calibration. Estimates were combined across databases using random-effects meta-analyses. Overall, 118 133 and 267 891 patients initiated third-generation β-blockers (carvedilol and nebivolol) or atenolol, respectively. The pooled hazard ratios (HRs) of acute myocardial infarction, stroke, hospitalization for heart failure, and most metabolic complications were not different between the third-generation β-blockers versus atenolol after propensity score matching and empirical calibration (HR, 1.07 [95% CI, 0.74–1.55] for acute myocardial infarction; HR, 1.06 [95% CI, 0.87–1.31] for stroke; HR, 1.46 [95% CI, 0.99–2.24] for hospitalized heart failure). Third-generation β-blockers were associated with significantly higher risk of stroke than ACE (angiotensin-converting enzyme) inhibitors (HR, 1.29 [95% CI, 1.03–1.72]) and thiazide diuretics (HR, 1.56 [95% CI, 1.17–2.20]). In conclusion, this study found many patients with first-line β-blocker monotherapy for hypertension and no statistically significant differences in the effectiveness and safety comparing atenolol with third-generation β-blockers. Patients on third-generation β-blockers had a higher risk of stroke than those on ACE inhibitors and thiazide diuretics.

scholarly journals Prospective follow-up of nebivolol in the treatment of arterial hypertension

2012 ◽  
Vol 140 (7-8) ◽  
pp. 425-430
Author(s):  
Nebojsa Despotovic ◽  
Danica Matic-Cvetkovic ◽  
Branislava Ivanovic
Keyword(s):  
Blood Pressure ◽  
Arterial Hypertension ◽  
Antihypertensive Effect ◽  
Metabolic Effects ◽  
Beta Blockade ◽  
Third Generation ◽  
Good Tolerability ◽  
Once Daily ◽  
Average Decrease

Introduction. Nebivolol, a third-generation beta-blocker (BB) shows a highly selective beta-blockade and specific vasodilating effects due to getting free nitro-oxide from the dysfunctional endothelium. Objective. The aim of the study was to investigate the antihypertensive effect of nebivolol in patients with arterial hypertension (AH) of both sexes. Methods. Systolic and diastolic blood pressure (BP), heart rate and serum glycemia, creatinin, cholesterol and trygliceride were measured after a 6-week treatment with a single 5 mg dose of nebivolol once daily so as to assess its efficacy and metabolic effects, as well as its tolerance by using a questionnaire answered by physicians and patients. Results. Out of 520 patients with mild or moderate AH, 430 (82.7%) were treated with nebivolol as monotherapy. After a 6-week treatment with nebivolol, with very good tolerability and neutral metabolic effects, systolic BP was significantly decreased (in male from initial 165?19 to 129?12 mm Hg, and female from initial 169?22 to 132?15 mm Hg at the end of the study; average decrease 22.3%, p<0.001) and as well as diastolic BP (male from initial 103?12 to 79?6 mm Hg and female from initial 100?9 to 82?7 mm Hg, average decrease 22.6%; p<0.001). Conclusion. After a 6-week treatment nebivolol significantly decreased systolic and diastolic BP in patients with mild and moderate AH, independently of the sex.

β-Blockers in Metabolic and Endocrine Perspectives

2020 ◽  
Vol 6 (1) ◽  
pp. 62-68
Author(s):  
Mohamad Arif ◽  
Nur Anna Chalimah Sadyah
Keyword(s):  
Adrenergic Receptor ◽  
Receptor Activation ◽  
Metabolic Effects ◽  
Protein Activation ◽  
Thyroid Hormone Metabolism ◽  
G Protein Activation ◽  
Receptor Blockers ◽  
Initial Generation ◽  
Β Blocker ◽  
Β Blockers

Catecholamine, through α-adrenergic receptor and β-adrenergic receptor activation, plays many roles in body’s physiological and pathophysiologicalprocesses. β-adrenergic receptor has different effect pursuant to receptor type, receptor location and G protein activation in the receptor. Beta receptor blockers (β-blockers) are a drug commonly used for cardiovascular disease. There are 3 different generations of β-blockers. In addition to their great advantages in cardiovascular, β-blockers also have metabolic and endocrine effects. β-blocker may influence sugar and insulin, fat, melatonin, cancer, blood uric acid and thyroid hormone metabolism. These metabolic effects may be disadvantageous, which mostly takes place with initial generation β-blockers. Third generation β-blockers do not show disadvantageous metabolic effect. However, early generation β-blockers may be advantageous in certain condition.

Optimal dosage of β-blockers using metoprolol CR/XL as an example – what, for whom and when?

2020 ◽  
Vol 13 (4) ◽  
pp. 424-429
Author(s):  
Radosław Grabysa
Keyword(s):  
Treatment Guidelines ◽  
Current Treatment ◽  
Optimal Dosage ◽  
Intrinsic Sympathomimetic Activity ◽  
Metoprolol Succinate ◽  
Clinical Scenarios ◽  
Pharmaceutical Form ◽  
Β Blocker ◽  
Β Blockers ◽  
Artery Disease

Metoprolol, a highly cardioselective β-blocker without intrinsic sympathomimetic activity, continues to play an important role in current treatment guidelines for hypertension, chronic heart failure, and coronary artery disease. Experts pay special attention to its modern, slow-release pharmaceutical form in the form of succinate, thoroughly tested in a number of clinical trials. Metoprolol succinate can be used in a single daily dose which ensures high compliance. The paper presents typical clinical scenarios in which appropriately dosed metoprolol CR/XL should be used. It should be emphasized that metoprolol CR/XL has the most registration indications among all the original β-blockers.

scholarly journals The role of vasodilating β-blockers in controlling arterial hypertension as a means of reducing cardiovascular and stroke risk

2011 ◽  
Vol 10 (3) ◽  
pp. 97-102
Author(s):  
Jan N. Basile
Keyword(s):  
Total Mortality ◽  
Renin Angiotensin System ◽  
Channel Blockers ◽  
National Guidelines ◽  
Angiotensin System ◽  
Wide Range ◽  
Β Blocker ◽  
Β Blockers ◽  
Cvd Mortality

β-blockers have played a key role in the management of hypertension-related cardiovascular disease for decades, and continue to be recommended as a mainstay of therapy in national guidelines statements. Recent data have shown less optimal reductions in total mortality, CVD mortality, and CVD events with β-blockers compared with renin-angiotensin system-blocking agents or calcium channel blockers. The β-blocker class, however, spans a wide range of agents, and the growing concern about the risk-benefit profile of β-blockers should not be generalized to later-generation vasodilating β-blockers such as carvedilol and nebivolol. A growing database from hypertension studies confirms the clinical efficacy and safety of vasodilating β-blockers, and outcome studies indicate that these agents can play an important role in global CVD reduction in patients with hypertensive or ischemic heart failure.

scholarly journals The role of vasodilating β-blockers in patients with complicated hypertension: focus on nebivolol

2011 ◽  
Vol 10 (6) ◽  
pp. 94-98
Author(s):  
T. D. Giles
Keyword(s):  
African American ◽  
Endothelial Dysfunction ◽  
Elderly Patients ◽  
Mortality And Morbidity ◽  
Patient Groups ◽  
Β Blocker ◽  
Β Blockers

Despite their proven mortality and morbidity outcomes benefits, β-blockers remain substantially underused in patients with cardiac conditions. Reluctance to prescribe β-blockers may be owing to concerns about tolerability with the traditional drugs in this class. β-blockers with vasodilatory properties, such as carvedilol and nebivolol, may overcome the tolerability and metabolic issues associated with traditional β-blockers. Because endothelial dysfunction, the pathophysiologic hallmark of hypertension, may be heightened in populations with difficult-totreat hypertension (e.g., elderly patients, African American patients), a vasodilating β-blocker may be a particularly appropriate choice for these patient groups.

Sign in / Sign up

Export Citation Format

Share Document