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Author Notes:

Corresponding Author: Arshed A. Quyyumi, MD, Professor of Medicine, Division of Cardiology, Co-Director, Emory Clinical Cardiovascular Research Institute, 1462 Clifton Road N.E. Suite 510, Atlanta GA 30322, Tel: 404 727 3655, Fax: 404 712 8785, Email:aquyyum@emory.edu

The authors wish to thank the dedicated nursing and support staff of the Emory Clinical Research Network and referring phyicians without whom this study would not have been possible.

None of the authors have conflicts of interests to disclose.

Subjects:

Research Funding:

This work was supported by an investigator initiated grant from Forest Pharmacuticals and in part by American Heart Association Postdoctoral Fellowship Grant 11POST7140036 (R.B.N.) and by the National Center for Advancing Translational Sciences of the National Institutes of Health under Award Number UL1TR000454.

Keywords:

  • Science & Technology
  • Life Sciences & Biomedicine
  • Peripheral Vascular Disease
  • Cardiovascular System & Cardiology
  • ENDOTHELIUM-DEPENDENT VASODILATION
  • EXERCISE-INDUCED VASODILATION
  • FOREARM RESISTANCE VESSELS
  • HYPERPOLARIZING FACTOR
  • VASCULAR RELAXATION
  • PEROXYNITRITE RELEASE
  • MENTAL STRESS
  • BETA-BLOCKERS
  • BLOOD-FLOW
  • DISEASE

Nitric Oxide Contributes to Vasomotor Tone in Hypertensive African Americans Treated With Nebivolol and Metoprolol

Tools:

Journal Title:

Journal of Clinical Hypertension

Volume:

Volume 18, Number 3

Publisher:

, Pages 223-231

Type of Work:

Article | Post-print: After Peer Review

Abstract:

Endothelial dysfunction is more prevalent in African Americans (AAs) compared with whites. The authors hypothesized that nebivolol, a selective β1-antagonist that stimulates nitric oxide (NO), will improve endothelial function in AAs with hypertension when compared with metoprolol. In a double-blind, randomized, crossover study, 19 AA hypertensive patients were randomized to a 12-week treatment period with either nebivolol 10 mg or metoprolol succinate 100 mg daily. Forearm blood flow (FBF) was measured using plethysmography at rest and after intra-arterial infusion of acetylcholine and sodium nitroprusside to estimate endothelium-dependent and independent vasodilation, respectively. Physiologic vasodilation was assessed during hand-grip exercise. Measurements were repeated after NO blockade with L-NG-monomethylarginine (L-NMMA) and after inhibition of endothelium-derived hyperpolarizing factor (EDHF) with tetraethylammonium chloride (TEA). NO blockade with L-NMMA produced a trend toward greater vasoconstriction during nebivolol compared with metoprolol treatment (21% vs 12% reduction in FBF, P=.06, respectively). This difference was more significant after combined administration of L-NMMA and TEA (P<.001). Similarly, there was a contribution of NO to exercise-induced vasodilation during nebivolol but not during metoprolol treatment. There were significantly greater contributions of NO and EDHF to resting vasodilator tone and of NO to exercise-induced vasodilation with nebivolol compared with metoprolol in AAs with hypertension.

Copyright information:

© 2016 Wiley Periodicals, Inc.

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