Integrated effects of the vasodilating beta-blocker nebivolol on exercise performance, energy metabolism, cardiovascular and neurohormonal parametersin physically active patients with arterial hypertension

Objective. The present study was designed to investigate the integrated eff ects of the beta-1-selective blocker with vasodilator properties, nebivolol , on systemic haemodynamics, neurohormones and energy metabolism as well as oxygen uptake and exercise performance in physically active patients with moderate essential hypertension (EH). Design and methods: Eighteen physically active patients with moderate EH we re included: age: 46.9 +/- 2.38 years, weight: 83.9 +/- 2.81 kg, blood pres sure (BP): 155.8 +/- 3.90/102.5 +/- 1.86 mm Hg, heart rate: 73.6 +/- 2.98 m in(-1). After a 14-day wash-out period a bicycle spiroergometry until exhau stion (WHO) was performed followed by a 45-min submaximal exercise test on the 2.5 mmol/l lactate-level 48 h later. Before, during and directly after exercise testing blood samples were taken. An identical protocol was repeat ed after a 6-week treatment period with 5 mg nebivolol/day. Results: Nebivolol treatment resulted in a significant (P < 0.01) decrease in systolic and diastolic BP and heart rate at rest and during maximal and submaximal exercise. Maximal physical work performance, blood lactate and r el. oxygen uptake (rel. VO2) before and after nebivolol treatment at rest a nd during maximal and submaximal exercise remained unaltered. Free fatty ac id, free glycerol, plasma catecholamines, beta-endorphines and atrial natri uretic peptide (ANP) increased before and after treatment during maximal an d submaximal exercise but remained unaltered by nebivolol treatment. In con trast, plasma ANP levels at rest were significantly higher in the presence of nebivolol, endothelin-1 levels were unchanged. Conclusions. Nebivolol was effective in the control of BP at rest and durin g exercise in patients with EH. Furthermore, nebivolol did not negatively a ffect lipid and carbohydrate metabolism and substrate flow. The explanation for the effects on ANP at rest remain elusive. This pharmacodynamic profil e of nebivolol is potentially suitable in physically active patients with E H.