Comparative effects of nebivolol and metoprolol on oxidative stress, insulin resistance, plasma adiponectin and soluble P-selectin levels in hypertensive patients

J Hypertens. 2006 Mar;24(3):591-6. doi: 10.1097/01.hjh.0000209993.26057.de.

Abstract

Objectives: To determine the effects of nebivolol on oxidative stress, insulin resistance, adiponectin and plasma soluble P-selectin levels in hypertensive patients in comparison with metoprolol.

Material and methods: Eighty newly diagnosed hypertensive patients in grade 1 hypertension according to the European Society of Hypertension and European Society of Cardiology guidelines were enrolled in this prospective, blinded, randomized study. Seventy-two patients completed the study. After baseline assessment, each patient was randomly allocated to a 5 mg daily dose of nebivolol (n = 37, 20 male) or a 100 mg daily dose of metoprolol (n = 35, 18 male) and treated for 6 months. Blood pressure, heart rate, oxidative stress (malonyldialdehyde), homeostasis model assessment: insulin resistance, adiponectin and plasma soluble P-selectin levels were measured before and after treatment.

Results: At the end of treatment, nebivolol and metoprolol significantly decreased blood pressure and heart rate, with a more pronounced bradycardic effect of metoprolol. Nebivolol, but not metoprolol, significantly lowered oxidative stress (P = 0.03), the insulin resistance index (P = 0.003) and plasma soluble P-selectin levels (P = 0.008), and increased adiponectin levels (P = 0.04).

Conclusion: Nebivolol, in contrast to metoprolol, improved oxidative stress, insulin sensitivity, decreased plasma soluble P-selectin and increased adiponectin levels in hypertensive patients. These beneficial effects of nebivolol may contribute to a reduction in cardiovascular risk in hypertensive patients.

Publication types

  • Clinical Trial
  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Adiponectin / blood
  • Adult
  • Antihypertensive Agents / pharmacology
  • Antihypertensive Agents / therapeutic use
  • Benzopyrans / pharmacology*
  • Benzopyrans / therapeutic use
  • Ethanolamines / pharmacology*
  • Ethanolamines / therapeutic use
  • Female
  • Humans
  • Hypertension / blood
  • Hypertension / drug therapy*
  • Insulin Resistance*
  • Male
  • Metoprolol / pharmacology*
  • Metoprolol / therapeutic use
  • Middle Aged
  • Nebivolol
  • Oxidative Stress / drug effects*
  • P-Selectin / blood
  • P-Selectin / drug effects
  • Prospective Studies
  • Single-Blind Method

Substances

  • Adiponectin
  • Antihypertensive Agents
  • Benzopyrans
  • Ethanolamines
  • P-Selectin
  • Nebivolol
  • Metoprolol