The impact of third-generation Beta-blocker antihypertensive treatment on endothelial function and the prothrombotic state

• Published in: American journal of hypertension 2004-07, Vol.17 (7), p.582-589
• Main Authors: Vyssoulis, Gregory P., Marinakis, Andreas G., Aznaouridis, Konstantinos A., Karpanou, Eva A., Arapogianni, Athina N., Cokkinos, Dennis V., Stefanadis, Christodoulos I.
• Format: Article
• Language: English
• Subjects: endothelial function; Hypertension; prothrombotic state; third-generation beta blockers
• ISSN: 0895-7061; 1941-7225; 1879-1905
• DOI: 10.1016/j.amjhyper.2004.03.668

Background: The significance of β-blockers in the treatment of cardiovascular diseases is well established. The effect of vasodilating β-blockers on endothelial function and prothrombotic state has not been investigated. Methods: The study comprised 550 consecutive patients with uncomplicated essential hypertension. They were treated with celiprolol, carvedilol or nebivolol monotherapy (171, 179, and 200 patients, respectively), achieving comparable blood pressure reduction. Plasma levels of fibrinogen and homocystine and serum levels of plasminogen activator inhibitor–1 (PAI-1) were obtained before and 6 months after initiation of treatment. Results: The three drugs differentiated in regard to homocystine (P < .00001) and fibrinogen level changes (P = .00003), but not (P = NS) in PAI-1 change. In smokers, differentiation was found in all three parameters (P = .0002, P = .001, and P = .006 for fibrinogen, PAI-1, and homocystine, respectively), but in nonsmokers differentiation was found only in homocystine change (P = .00003). In smokers, fibrinogen, PAI-1, and homocystine were reduced more (P = .002, P = .0009, and P