Differential effects of nebivolol and metoprolol on central aortic pressure and left ventricular wall thickness

Hypertension. 2011 Jun;57(6):1122-8. doi: 10.1161/HYPERTENSIONAHA.110.155507. Epub 2011 May 2.

Abstract

The aim of this study was to investigate the effects of the vasodilating β-blocker nebivolol and the cardioselective β-blocker metoprolol succinate on aortic blood pressure and left ventricular wall thickness. We conducted a randomized, double-blind study on 80 hypertensive patients. The patients received either 5 mg of nebivolol or 50 to 100 mg of metoprolol succinate daily for 1 year. Their heart rate, central and brachial blood pressures, mean arterial pressure, augmentation index, carotid-femoral pulse wave velocity, and left ventricular wall thickness were measured at baseline and at the end of the study. Nebivolol and metoprolol significantly reduced heart rate, brachial blood pressure, and mean arterial pressure to the same degree. However, reductions in central systolic and diastolic blood pressures, central pulse pressure, and left ventricular wall thickness were significant only in the nebivolol group. The change in left ventricular septal wall thickness was significantly correlated with central systolic blood pressure change (r=0.41; P=0.001) and with central pulse pressure change (r=0.32; P=0.01). No significant changes in augmentation index or carotid-femoral pulse wave velocity were detected in either treatment group. This proof-of-principle study provides evidence to suggest that β-blockers with vasodilating properties may offer advantages over conventional β-blockers in antihypertensive therapy; however, this remains to be tested in a larger trial.

Trial registration: ClinicalTrials.gov NCT01248338.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Antihypertensive Agents / therapeutic use
  • Aorta / physiopathology
  • Benzopyrans / therapeutic use*
  • Blood Pressure / drug effects*
  • Carotid Arteries / drug effects
  • Carotid Arteries / physiopathology
  • Double-Blind Method
  • Echocardiography
  • Ethanolamines / therapeutic use*
  • Female
  • Femoral Artery / drug effects
  • Femoral Artery / physiopathology
  • Heart Rate / drug effects
  • Heart Ventricles
  • Hemodynamics / drug effects
  • Humans
  • Hypertension / drug therapy*
  • Hypertension / pathology
  • Hypertension / physiopathology
  • Male
  • Metoprolol / therapeutic use*
  • Middle Aged
  • Myocardium / pathology
  • Nebivolol
  • Pulse
  • Treatment Outcome

Substances

  • Antihypertensive Agents
  • Benzopyrans
  • Ethanolamines
  • Nebivolol
  • Metoprolol

Associated data

  • ClinicalTrials.gov/NCT01248338