This Article Figures Only Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Münzel, T. Articles by Gori, T. Search for Related Content PubMed PubMed Citation Articles by Münzel, T. Articles by Gori, T. Related Collections Related Article

STATE-OF-THE-ART PAPER

Nebivolol

The Somewhat-Different β-Adrenergic Receptor Blocker

II Medizinische Klinik für Kardiologie/Angiologie, Mainz, Germany

Manuscript received April 14, 2009; accepted May 6, 2009.

^_* Reprint requests and correspondence: Dr. Thomas Münzel, II Medizinische Klinik für Kardiologie/Angiologie, Langenbeckstrasse 1, 55131 Mainz, Germany (Email: tmuenzel{at}uni-mainz.de).

Although its clinical use in Europe dates almost 10 years, nebivolol is a β-blocker that has been only recently introduced in the U.S. market. Like carvedilol, nebivolol belongs to the third generation of β-blockers, which possess direct vasodilator properties in addition to their adrenergic blocking characteristics. Nebivolol has the highest β₁-receptor affinity among β-blockers and, most interestingly, it substantially improves endothelial dysfunction via its strong stimulatory effects on the activity of the endothelial nitric oxide synthase and via its antioxidative properties. Because impaired endothelial activity is attributed a major causal role in the pathophysiology of hypertension, coronary artery disease, and congestive heart failure, the endothelium-agonistic properties of nebivolol suggest that this drug might provide additional benefit beyond β-receptor blockade. Although lesser β-blocker–related side effects have been reported in patients with chronic obstructive pulmonary disease or impotence taking nebivolol, side effects and contraindications overlap those of other β-blockers. Clinically, this compound has been proven to have antihypertensive and anti-ischemic effects as well as beneficial effects on hemodynamics and prognosis in patients with chronic congestive heart failure. Further studies are now necessary to compare the benefit of nebivolol with that of other drugs in the same class and, most importantly, its prognostic impact in patients with hypertension.

Key Words: nitric oxide • oxidative stress • beta-receptor blockade • vasodilation • nitric oxide synthase

Abbreviations and Acronyms   ACE = angiotensin-converting enzyme   eNOS = endothelial nitric oxide synthase   NO = nitric oxide

Related Article

Inside This Issue
J. Am. Coll. Cardiol. 2009 54: A32. [Full Text] [PDF]

This article has been cited by other articles:

				V. M. Conraads, M. Metra, O. Kamp, G. W. De Keulenaer, B. Pieske, J. Zamorano, P. E. Vardas, M. Bohm, and L. Dei Cas Effects of the long-term administration of nebivolol on the clinical symptoms, exercise capacity, and left ventricular function of patients with diastolic dysfunction: results of the ELANDD study Eur J Heart Fail, February 1, 2012; 14(2): 219 - 225. [Abstract] [Full Text] [PDF]

				C. Espinola-Klein, G. Weisser, A. Jagodzinski, S. Savvidis, A. Warnholtz, M.-A. Ostad, T. Gori, and T. Munzel {beta}-Blockers in Patients With Intermittent Claudication and Arterial Hypertension: Results From the Nebivolol or Metoprolol in Arterial Occlusive Disease Trial Hypertension, August 1, 2011; 58(2): 148 - 154. [Abstract] [Full Text] [PDF]

				Y. K. Xiang Compartmentalization of {beta}-Adrenergic Signals in Cardiomyocytes Circ. Res., July 8, 2011; 109(2): 231 - 244. [Abstract] [Full Text] [PDF]

				A. S. Dery, L. A. Hamilton, and J. A. Starr Nebivolol for the treatment of heart failure Am. J. Health Syst. Pharm., May 15, 2011; 68(10): 879 - 886. [Abstract] [Full Text] [PDF]

				G. Ambrosio, M. D. Flather, M. Bohm, A. Cohen-Solal, A. Murrone, F. Mascagni, G. Spinucci, M. G. Conti, D. J. van Veldhuisen, L. Tavazzi, et al. {beta}-blockade with nebivolol for prevention of acute ischaemic events in elderly patients with heart failure Heart, February 1, 2011; 97(3): 209 - 214. [Abstract] [Full Text] [PDF]

				T. Munzel, T. Gori, R. M. Bruno, and S. Taddei Is oxidative stress a therapeutic target in cardiovascular disease? Eur. Heart J., November 2, 2010; 31(22): 2741 - 2748. [Abstract] [Full Text] [PDF]

				K. C. Wu and G. Gerstenblith Review: Update on Newer Antihypertensive Medicines and Interventions Journal of Cardiovascular Pharmacology and Therapeutics, September 1, 2010; 15(3): 257 - 267. [Abstract] [PDF]