Differential Metabolic Effects of Beta-Blockers: an Updated Systematic Review of Nebivolol
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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.
KeywordsHypertension Insulin sensitivity Lipid metabolism Nebivolol Obesity
Editorial support for the preparation of this manuscript was provided by the SPRIM Company, Singapore, through an unrestricted educational grant by A. Menarini.
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Conflict of Interest
Drs. Marketou, Gupta, and Vardas declare no conflicts of interest relevant to this manuscript. Dr. Jain reports grants from A. Manarini, Singapore, and support from SPRIM Asia Pacific Ltd, Singapore.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
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