Vascular Effects of Nebivolol Added to Hydrochlorothiazide in African Americans With Hypertension and Echocardiographic Evidence of Diastolic Dysfunction
| Autor: | Tahir Haque, Junior Harris, Sujan Bhaheetharan, Syed T. Rahman, Jessica E. Wahi, Bobby V. Khan, Keith C. Ferdinand, Nadya Merchant, Kanwal Umar |
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| Rok vydání: | 2012 |
| Předmět: |
Adult
Male medicine.medical_specialty Endothelium medicine.medical_treatment Diastole Arginine Nitric Oxide Nebivolol Nitric oxide chemistry.chemical_compound Hydrochlorothiazide Internal medicine medicine Humans Benzopyrans Pharmacology (medical) Antihypertensive Agents Nitrites Aged Pharmacology Heart Failure Diastolic Nitrates Dose-Response Relationship Drug business.industry Middle Aged medicine.disease Black or African American Blood pressure medicine.anatomical_structure chemistry Echocardiography Ethanolamines Heart failure Hypertension Cardiology Drug Therapy Combination Female Diuretic Cardiology and Cardiovascular Medicine business medicine.drug |
| Zdroj: | Journal of Cardiovascular Pharmacology and Therapeutics. 17:291-297 |
| ISSN: | 1940-4034 1074-2484 |
| Popis: | African Americans have greater risk of cardiovascular events than comparator populations of white European origin. A potential reason for this is reduced nitric oxide bioavailability in African Americans, resulting in increased prevalence of factors that contribute to ventricular dysfunction. We investigated the effects of nebivolol with the diuretic hydrochlorothiazide (HCTZ) in hypertensive African Americans with echocardiographic evidence of diastolic dysfunction.A total of 42 African American patients were assigned to nebivolol and HCTZ in an open-label fashion for a 24-week period. Changes in blood pressure (BP), echocardiographic parameters, and success in attaining target BP were determined. As an indirect determinant of endothelial function, serum total nitric oxide (NOx) levels and asymmetric dimethyl arginine (ADMA) levels were performed at baseline and after the treatment period.The systolic BP decreased from 150 ± 13 to 136 ± 16 mm Hg (P.005). Diastolic BP decreased from 94 ± 13 to 84 ± 9 mm Hg (P = .008). Of the patients that completed the study, 77% achieved a combined target BP of systolic BP140 mm Hg and a diastolic BP90 mm Hg. Serum NOx increased by 41% and 39% in patients that were treated with 10 mg and 20 mg daily nebivolol, respectively. The ADMA levels decreased by 44% following treatment. The change in systolic BP was strongly correlated to the change in ADMA (r = .54; P = .024). Furthermore, in comparison to a group of age-matched patients controlled with diuretic therapy only, the ADMA levels were significantly lower in the nebivolol posttreatment group (controlled BP with diuretic: 0.32 ± 0.07μmol/L; nebivolol posttreatment: 0.24 ± 0.06 μmol/L; P.05).Reduced BP with nebivolol in hypertensive African Americans and echocardiographic evidence of diastolic dysfunction correlates with improved endothelial function. Furthermore, improvement in endothelial function and increased nitric oxide bioavailability suggests a potential mechanism of efficacy of nebivolol in these patients. |
| Databáze: | OpenAIRE |
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