Differential effects of nebivolol and metoprolol on arterial stiffness, circulating progenitor cells, and oxidative stress

J Am Soc Hypertens. 2015 Mar;9(3):206-13. doi: 10.1016/j.jash.2014.12.013. Epub 2014 Dec 31.

Abstract

Unlike traditional beta receptor antagonists, nebivolol activates nitric oxide. We hypothesized that therapy with nebivolol compared with metoprolol would improve arterial stiffness, increase levels of circulating progenitor cells (PC), and decrease oxidative stress (OS). In a randomized, double-blind, cross-over study, 30 hypertensive subjects received either once daily nebivolol or metoprolol succinate for 3 months each. Pulse wave velocity and augmentation index were measured using tonometry. Flow cytometry was used to measure circulating PC. OS was measured as plasma aminothiols. Measurements were performed at baseline, and repeated at 3 and 6 months. No significant differences were present between the levels of OS, arterial stiffness, and PC numbers during treatment with metoprolol compared with nebivolol. In subgroup analyses of beta-blocker naïve subjects (n = 19), nebivolol reduced pulse wave velocity significantly compared with metoprolol (-1.4 ± 1.9 vs. -0.1 ± 2.2; P = .005). Both nebivolol and metoprolol increased circulating levels of CD34+/CD133 + PC similarly (P = .05), suggesting improved regenerative capacity.

Trial registration: ClinicalTrials.gov NCT01041287.

Keywords: CD133; CD34; Pulse wave velocity; aminothiols; beta blocker.

Publication types

  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Antihypertensive Agents / administration & dosage
  • Blood Pressure / drug effects*
  • Cross-Over Studies
  • Double-Blind Method
  • Drug Monitoring
  • Female
  • Humans
  • Hypertension* / diagnosis
  • Hypertension* / drug therapy
  • Hypertension* / metabolism
  • Hypertension* / physiopathology
  • Male
  • Metoprolol / administration & dosage*
  • Middle Aged
  • Nebivolol / administration & dosage*
  • Nitric Oxide / metabolism
  • Oxidative Stress / drug effects*
  • Pulse Wave Analysis
  • Stem Cells / metabolism*
  • Treatment Outcome
  • Vascular Stiffness / drug effects*

Substances

  • Antihypertensive Agents
  • Nebivolol
  • Nitric Oxide
  • Metoprolol

Associated data

  • ClinicalTrials.gov/NCT01041287