Differential Metabolic Effects of Beta-Blockers: An Updated Systematic Review of Nebivolol

Curr Hypertens Rep. 2017 Mar;19(3):22. doi: 10.1007/s11906-017-0716-3.

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.

Keywords: Hypertension; Insulin sensitivity; Lipid metabolism; Nebivolol; Obesity.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Adrenergic beta-Antagonists / therapeutic use*
  • Antihypertensive Agents / therapeutic use*
  • Blood Pressure / drug effects*
  • Diabetes Mellitus / drug therapy
  • Ethanolamines / pharmacology
  • Hemodynamics / drug effects
  • Humans
  • Hypertension / drug therapy*
  • Insulin Resistance
  • Metabolic Syndrome / drug therapy*
  • Nebivolol / therapeutic use*
  • Nitric Oxide / metabolism

Substances

  • Adrenergic beta-Antagonists
  • Antihypertensive Agents
  • Ethanolamines
  • Nebivolol
  • Nitric Oxide