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Effect of treatment with nebivolol on parameters of oxidative stress in type 2 diabetics with mild to moderate hypertension
Author(s) -
Peter P.,
Martin U.,
Sharma A.,
Dunne F.
Publication year - 2006
Publication title -
journal of clinical pharmacy and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.622
H-Index - 73
eISSN - 1365-2710
pISSN - 0269-4727
DOI - 10.1111/j.1365-2710.2006.00718.x
Subject(s) - nebivolol , medicine , blood pressure , lipid profile , endocrinology , diastole , oxidative stress , cholesterol , ambulatory blood pressure
Summary Aim: The aim of this study was to examine the effect of the cadioselective B 1 ‐adrenoceptor blocker nebivolol on glycaemic control, lipid profile and markers of oxidative stress in patients with type 2 diabetes over a 6‐month period. Methods: Twenty‐six patients with mild to moderate hypertension (140–160 mmHg systolic, 90–105 mmHg diastolic) confirmed on 24‐h blood pressure monitoring, were treated with nebivolol 5 mg daily for 6 months. Total serum cholesterol, triglycerides, high‐density lipoprotein (HDL) cholesterol and low‐density lipoprotein (LDL) subfractions, lipid hydroperoxides (LHPs) and total antioxidant capacity (TAC) were measured before and after 6 months of treatment. Results: Nebivolol, as expected, reduced mean daytime systolic and diastolic pressures on ambulatory monitoring (149 ± 9 to 140 ± 13 mmHg, P = 0·02 and 84 ± 7 to 77 ± 9 mmHg, P < 0·001). There were no significant changes in serum cholesterol or triglycerides following treatment but a significant increase in HDL cholesterol was noted (1·12 ± 0·19 to 1·25 ± 0·36 mmol/L, P = 0·008). Patients showed a highly significant reduction in TAC from 501 ± 57 to 422 ± 29 trolox equivalent ( P < 0·001). Baseline LHPs were very high and showed no significant change over the 6‐month period (18·7 ± 7·4 and 18·7 ± 10·9 μ mol/L). The LDL score increased significantly from 1·7 ± 0·7 to 2·3 ± 0·7 ( P = 0·0002) at 6 months suggesting a change to a more atherogenic lipid profile. Neither weight nor glycaemic control changed during treatment. Conclusion: Nebivolol appears to be lipid neutral and may even have a positive effect on HDL cholesterol. Despite this it may promote the formation of potentially atherogenic LDL subfractions possibly as a result of reduced antioxidant defences. Further studies are needed to clarify the changes observed in parameters of oxidative stress.