Effects of Nebivolol on Skeletal Muscle During Exercise in Hypertensive Patients

Summary

The purpose of this study is to determine if Nebivolol improves microvascular perfusion in skeletal muscle during exercise in hypertensive patients and whether this improvement is accompanied by reduction in vascular oxidative stress or increased endothelial nitric oxide synthase (eNOS) expression in humans.

Timeline

Start

2010-08

Primary completion

2015-12

Completion

2015-12

Publications

• Background Hamada M, Kazatani Y, Shigematsu Y, Ito T, Kokubu T, Ishise S. Enhanced blood pressure response to isometric handgrip exercise in patients with essential hypertension: effects of propranolol and prazosin. J Hypertens. 1987 Jun;5(3):305-9. doi: 10.1097/00004872-198706000-00007.
• Background Saitoh M, Miyakoda H, Kitamura H, Kinugawa T, Hisatome I, Kotake H, Mashiba H. Cardiovascular and sympathetic nervous response to dynamic exercise in patients with essential hypertension. Intern Med. 1992 May;31(5):606-10. doi: 10.2169/internalmedicine.31.606.
• Background Glezer GA, Lediashova GA. Changes in general haemodynamics and renal function during exercise in patients with arterial hypertension. Cor Vasa. 1975;17(1):1-13.
• Background Kazatani Y, Hamada M, Shigematsu Y, Hiwada K, Kokubu T. Beneficial Effect of a Long-Term Antihypertensive Therapy on Blood Pressure Response to Isometric Handgrip Exercise in Patients with Essential Hypertension. Am J Ther. 1995 Mar;2(3):165-169. doi: 10.1097/00045391-199503000-00003.
• Background Marraccini P, Palombo C, Giaconi S, Michelassi C, Genovesi-Ebert A, Marabotti C, Fommei E, Ghione S, L'Abbate A. Reduced cardiovascular efficiency and increased reactivity during exercise in borderline and established hypertension. Am J Hypertens. 1989 Dec;2(12 Pt 1):913-6. doi: 10.1093/ajh/2.12.913.
• Background Kokkinos PF, Andreas PE, Coutoulakis E, Colleran JA, Narayan P, Dotson CO, Choucair W, Farmer C, Fernhall B. Determinants of exercise blood pressure response in normotensive and hypertensive women: role of cardiorespiratory fitness. J Cardiopulm Rehabil. 2002 May-Jun;22(3):178-83. doi: 10.1097/00008483-200205000-00009.
• Background Schutz W, Hortnagl H, Magometschnigg D. Function of the autonomic nervous system in young, untreated hypertensive patients. Int J Cardiol. 1986 Feb;10(2):133-40. doi: 10.1016/0167-5273(86)90221-4.
• Background Goodman JM, McLaughlin PR, Plyley MJ, Holloway RM, Fell D, Logan AG, Liu PP. Impaired cardiopulmonary response to exercise in moderate hypertension. Can J Cardiol. 1992 May;8(4):363-71.
• Background Lund-Johansen P. Twenty-year follow-up of hemodynamics in essential hypertension during rest and exercise. Hypertension. 1991 Nov;18(5 Suppl):III54-61. doi: 10.1161/01.hyp.18.5_suppl.iii54.
• Background de Champlain J, Petrovich M, Gonzalez M, Lebeau R, Nadeau R. Abnormal cardiovascular reactivity in borderline and mild essential hypertension. Hypertension. 1991 Apr;17(4 Suppl):III22-8. doi: 10.1161/01.hyp.17.4_suppl.iii22.
• Background Zhao W, Swanson SA, Ye J, Li X, Shelton JM, Zhang W, Thomas GD. Reactive oxygen species impair sympathetic vasoregulation in skeletal muscle in angiotensin II-dependent hypertension. Hypertension. 2006 Oct;48(4):637-43. doi: 10.1161/01.HYP.0000240347.51386.ea. Epub 2006 Aug 28.
• Background Ladage D, Brixius K, Hoyer H, Steingen C, Wesseling A, Malan D, Bloch W, Schwinger RH. Mechanisms underlying nebivolol-induced endothelial nitric oxide synthase activation in human umbilical vein endothelial cells. Clin Exp Pharmacol Physiol. 2006 Aug;33(8):720-4. doi: 10.1111/j.1440-1681.2006.04424.x.
• Background Reidenbach C, Schwinger RH, Steinritz D, Kehe K, Thiermann H, Klotz T, Sommer F, Bloch W, Brixius K. Nebivolol induces eNOS activation and NO-liberation in murine corpus cavernosum. Life Sci. 2007 Jun 6;80(26):2421-7. doi: 10.1016/j.lfs.2007.04.016. Epub 2007 Apr 25.
• Background Bragadeesh T, Sari I, Pascotto M, Micari A, Kaul S, Lindner JR. Detection of peripheral vascular stenosis by assessing skeletal muscle flow reserve. J Am Coll Cardiol. 2005 Mar 1;45(5):780-5. doi: 10.1016/j.jacc.2004.11.045.
• Background Lindner JR, Womack L, Barrett EJ, Weltman J, Price W, Harthun NL, Kaul S, Patrie JT. Limb stress-rest perfusion imaging with contrast ultrasound for the assessment of peripheral arterial disease severity. JACC Cardiovasc Imaging. 2008 May;1(3):343-50. doi: 10.1016/j.jcmg.2008.04.001.
• Background Tzemos N, Lim PO, MacDonald TM. Nebivolol reverses endothelial dysfunction in essential hypertension: a randomized, double-blind, crossover study. Circulation. 2001 Jul 31;104(5):511-4. doi: 10.1161/hc3001.094207.
• Background Corretti MC, Anderson TJ, Benjamin EJ, Celermajer D, Charbonneau F, Creager MA, Deanfield J, Drexler H, Gerhard-Herman M, Herrington D, Vallance P, Vita J, Vogel R; International Brachial Artery Reactivity Task Force. Guidelines for the ultrasound assessment of endothelial-dependent flow-mediated vasodilation of the brachial artery: a report of the International Brachial Artery Reactivity Task Force. J Am Coll Cardiol. 2002 Jan 16;39(2):257-65. doi: 10.1016/s0735-1097(01)01746-6.
• Background Clerk LH, Vincent MA, Jahn LA, Liu Z, Lindner JR, Barrett EJ. Obesity blunts insulin-mediated microvascular recruitment in human forearm muscle. Diabetes. 2006 May;55(5):1436-42. doi: 10.2337/db05-1373.
• Background Womack L, Peters D, Barrett EJ, Kaul S, Price W, Lindner JR. Abnormal skeletal muscle capillary recruitment during exercise in patients with type 2 diabetes mellitus and microvascular complications. J Am Coll Cardiol. 2009 Jun 9;53(23):2175-83. doi: 10.1016/j.jacc.2009.02.042.
• Background Donato AJ, Gano LB, Eskurza I, Silver AE, Gates PE, Jablonski K, Seals DR. Vascular endothelial dysfunction with aging: endothelin-1 and endothelial nitric oxide synthase. Am J Physiol Heart Circ Physiol. 2009 Jul;297(1):H425-32. doi: 10.1152/ajpheart.00689.2008. Epub 2009 May 22.
• Background Gavin KM, Seals DR, Silver AE, Moreau KL. Vascular endothelial estrogen receptor alpha is modulated by estrogen status and related to endothelial function and endothelial nitric oxide synthase in healthy women. J Clin Endocrinol Metab. 2009 Sep;94(9):3513-20. doi: 10.1210/jc.2009-0278. Epub 2009 Jun 9.
• Background Colombo PC, Banchs JE, Celaj S, Talreja A, Lachmann J, Malla S, DuBois NB, Ashton AW, Latif F, Jorde UP, Ware JA, LeJemtel TH. Endothelial cell activation in patients with decompensated heart failure. Circulation. 2005 Jan 4;111(1):58-62. doi: 10.1161/01.CIR.0000151611.89232.3B. Epub 2004 Dec 20.
• Background Pierce GL, Lesniewski LA, Lawson BR, Beske SD, Seals DR. Nuclear factor-kappaB activation contributes to vascular endothelial dysfunction via oxidative stress in overweight/obese middle-aged and older humans. Circulation. 2009 Mar 10;119(9):1284-92. doi: 10.1161/CIRCULATIONAHA.108.804294. Epub 2009 Feb 23.
• Velasco A, Solow E, Price A, Wang Z, Arbique D, Arbique G, Adams-Huet B, Schwedhelm E, Lindner JR, Vongpatanasin W. Differential effects of nebivolol vs. metoprolol on microvascular function in hypertensive humans. Am J Physiol Heart Circ Physiol. 2016 Jul 1;311(1):H118-24. doi: 10.1152/ajpheart.00237.2016. Epub 2016 May 13.

Drugs

Indications