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Original Article

Effects of Nebivolol Versus Metoprolol on Sodium Sensitivity and Renal Sodium Handling in Hypertensive Hispanic Postmenopausal Women

Richard A. Preston, David Afshartous, Barry J. Materson, Rolando Rodco, Alberto B. Alonso
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https://doi.org/10.1161/HYPERTENSIONAHA.114.03476
Hypertension. 2014;HYPERTENSIONAHA.114.03476
Originally published May 19, 2014
Richard A. Preston
From the Clinical Pharmacology Research Unit, Division of Clinical Pharmacology, Department of Medicine, Miller School of Medicine, University of Miami, FL (R.A.P., D.A., B.J.M., R.R., A.B.A.); Jackson Memorial Hospital, Miami, FL (R.A.P.); Department of Cellular Biology and Pharmacology, Herbert Wertheim College of Medicine, Florida International University, Miami, FL (R.A.P.); Department of Biostatistics, Vanderbilt University School of Medicine, Nashville, TN (D.A.); and Department of Analytics, Affinnova, Waltham, MA (D.A.).
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David Afshartous
From the Clinical Pharmacology Research Unit, Division of Clinical Pharmacology, Department of Medicine, Miller School of Medicine, University of Miami, FL (R.A.P., D.A., B.J.M., R.R., A.B.A.); Jackson Memorial Hospital, Miami, FL (R.A.P.); Department of Cellular Biology and Pharmacology, Herbert Wertheim College of Medicine, Florida International University, Miami, FL (R.A.P.); Department of Biostatistics, Vanderbilt University School of Medicine, Nashville, TN (D.A.); and Department of Analytics, Affinnova, Waltham, MA (D.A.).
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Barry J. Materson
From the Clinical Pharmacology Research Unit, Division of Clinical Pharmacology, Department of Medicine, Miller School of Medicine, University of Miami, FL (R.A.P., D.A., B.J.M., R.R., A.B.A.); Jackson Memorial Hospital, Miami, FL (R.A.P.); Department of Cellular Biology and Pharmacology, Herbert Wertheim College of Medicine, Florida International University, Miami, FL (R.A.P.); Department of Biostatistics, Vanderbilt University School of Medicine, Nashville, TN (D.A.); and Department of Analytics, Affinnova, Waltham, MA (D.A.).
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Rolando Rodco
From the Clinical Pharmacology Research Unit, Division of Clinical Pharmacology, Department of Medicine, Miller School of Medicine, University of Miami, FL (R.A.P., D.A., B.J.M., R.R., A.B.A.); Jackson Memorial Hospital, Miami, FL (R.A.P.); Department of Cellular Biology and Pharmacology, Herbert Wertheim College of Medicine, Florida International University, Miami, FL (R.A.P.); Department of Biostatistics, Vanderbilt University School of Medicine, Nashville, TN (D.A.); and Department of Analytics, Affinnova, Waltham, MA (D.A.).
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Alberto B. Alonso
From the Clinical Pharmacology Research Unit, Division of Clinical Pharmacology, Department of Medicine, Miller School of Medicine, University of Miami, FL (R.A.P., D.A., B.J.M., R.R., A.B.A.); Jackson Memorial Hospital, Miami, FL (R.A.P.); Department of Cellular Biology and Pharmacology, Herbert Wertheim College of Medicine, Florida International University, Miami, FL (R.A.P.); Department of Biostatistics, Vanderbilt University School of Medicine, Nashville, TN (D.A.); and Department of Analytics, Affinnova, Waltham, MA (D.A.).
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Abstract

Several consistent lines of evidence indicate an association between sodium sensitivity and impaired nitric oxide bioactivity. Nevertheless, whether restoring nitric oxide in humans by pharmacological means can ameliorate sodium sensitivity has not been investigated. Because nebivolol has been demonstrated to increase nitric oxide bioactivity in both laboratory and clinical investigations, we hypothesized that nebivolol might ameliorate sodium sensitivity and improve renal sodium handling in comparison to metoprolol. We therefore conducted a randomized, 2-treatment-period crossover trial in 19 Hispanic postmenopausal women with hypertension to determine the comparative effects of nebivolol versus metoprolol on (1) 24-hour ambulatory blood pressure response to an increase in dietary sodium from 5 days of low sodium to 5 days of high sodium, (2) renal natriuretic response to a 1-L saline challenge, and (3) asymmetrical dimethylarginine. Clinic blood pressure and heart rate were significantly reduced after 4 weeks of treatment with both nebivolol and metoprolol. Twenty-four-hour mean systolic blood pressure increased sharply from low sodium to high sodium for both nebivolol and metoprolol. Nevertheless, the increases in blood pressure did not differ between the 2 drugs: 7.7 (3.1, 12.3) mm Hg with metoprolol and 9.3 (4.6, 13.9) mm Hg with nebivolol (P=0.63). Furthermore, we observed no differences between the drugs in natriuretic response to saline challenge or asymmetrical dimethylarginine. In a sodium-sensitive population, at doses sufficient to produce reductions in blood pressure and heart rate, nebivolol did not demonstrate a significant effect on sodium sensitivity or sodium handling compared with metoprolol.

  • hypertension
  • kidney
  • nitric oxide
  • sodium
  • Received March 3, 2014.
  • Revision received March 18, 2014.
  • Accepted April 18, 2014.
  • © 2014 American Heart Association, Inc.
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    Effects of Nebivolol Versus Metoprolol on Sodium Sensitivity and Renal Sodium Handling in Hypertensive Hispanic Postmenopausal Women
    Richard A. Preston, David Afshartous, Barry J. Materson, Rolando Rodco and Alberto B. Alonso
    Hypertension. 2014;HYPERTENSIONAHA.114.03476, originally published May 19, 2014
    https://doi.org/10.1161/HYPERTENSIONAHA.114.03476

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    Effects of Nebivolol Versus Metoprolol on Sodium Sensitivity and Renal Sodium Handling in Hypertensive Hispanic Postmenopausal Women
    Richard A. Preston, David Afshartous, Barry J. Materson, Rolando Rodco and Alberto B. Alonso
    Hypertension. 2014;HYPERTENSIONAHA.114.03476, originally published May 19, 2014
    https://doi.org/10.1161/HYPERTENSIONAHA.114.03476
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