Can beta-blockers have antiatherogenic properties – the example of nebivolol

Abstract:

Antagonists of beta-adrenergic receptors (beta-blockers) are undoubtedly among the most effective antihypertensive medications and crucial in secondary prevention of myocardial infarction. They are also beneficial for patients with heart failure and cardiac arrhythmias. Recently, it has been shown that treatment regimens based on these medications, with or without thiazide diuretics, are associated with a greater number of cases of new-onset diabetes than regimens based on some other antihypertensive drugs. The unfavourable effects of some beta-blockers on carbohydrate and lipid metabolism and insulin sensitivity have also contributed to the views that they should not be preferred in hypertensive patients with other cardiovascular risk factors. Conversely, this does not apply to vasodilatory beta-blockers, such as nebivolol, which have been shown to have favourable metabolic effects causing no change in total and LDL cholesterol, blood glucose level or bodyweight and even improving triglyceride and HDL cholesterol levels. Nebivolol also has antioxidant properties and increases NO production, thus improving endothelial dysfunction, which plays a key role in the pathogenesis of atherosclerosis. It has also been found to have a potentially protective role as it affects the expression of a number of genes involved in the appearance and progression of atherosclerosis. Thus, we may conclude that at least some beta-blockers have antiatherogenic properties

Key words:
adrenergic beta-antagonists; diabetes mellitus; hypercholesterolemia; myocardial infarction; nebivolol