Modern potential in the treatment of metabolic syndrome patients —focus on endothelium

Abstract

Numerous publications on the use of β-blockers in patients with arterial hypertension (AH) and metabolic syndrome (MS) have reported adverse effects of these medications on carbohydrate and lipid metabolism, as well as reduced cerebral perfusion. This review presents the benefits of a third-generation β-blocker — nebivolol (Nebilet®) — in the treatment of MS patients. The authors refer to their own findings that demonstrate effectiveness and safety of nebivolol monotherapy in individuals with AH and MS. Nebivolol treatment resulted in a sustained reduction of systolic and diastolic blood pressure levels and also improved carbohydrate and lipid metabolism parameters, which beneficially differentiates nebivolol from all other known β-blockers. Nebivolol treatment did not demonstrate any negative effects on thyroid hormone levels and reduced aldosterone levels. Nebivolol-induced increase in the endothelial production of nitric oxide resulted in a significant improvement of cerebral perfusion. Moreover, nebivolol treatment was associated with a reduction in mean 24-hour QT interval duration, which was increased at baseline. These findings suggest a beneficial effect of nebivolol on myocardial electrophysiology. Nebivolol appears to be a promising medication in the treatment of patients with MS and AH.