Vascular Effects of Nebivolol Added to Hydrochlorothiazide in African Americans With Hypertension and Echocardiographic Evidence of Diastolic Dysfunction: The NASAA Study

Background:African Americans have greater risk of cardiovascular events than comparator populations of white European origin. A potential reason for this is reduced nitric oxide bioavailability in African Americans, resulting in increased prevalence of factors that contribute to ventricular dysfunct...

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Bibliographic Details
Published in:Journal of cardiovascular pharmacology and therapeutics 2012-09, Vol.17 (3), p.291-297
Main Authors: Khan, Bobby V., Rahman, Syed T., Haque, Tahir, Merchant, Nadya, Bhaheetharan, Sujan, Harris, Junior, Umar, Kanwal, Wahi, Jessica, Ferdinand, Keith C.
Format: Article
Language:English
Subjects:
Adult
African Americans
Aged
Antihypertensive Agents - administration & dosage
Antihypertensive Agents - therapeutic use
Arginine - analogs & derivatives
Arginine - blood
Benzopyrans - administration & dosage
Benzopyrans - therapeutic use
Dose-Response Relationship, Drug
Drug Therapy, Combination
Echocardiography
Ethanolamines - administration & dosage
Ethanolamines - therapeutic use
Female
Heart Failure, Diastolic - pathology
Humans
Hydrochlorothiazide - administration & dosage
Hydrochlorothiazide - therapeutic use
Hypertension - drug therapy
Male
Middle Aged
Nebivolol
Nitrates - blood
Nitrates - metabolism
Nitric Oxide - blood
Nitrites - blood
Nitrites - metabolism
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Summary:Background:African Americans have greater risk of cardiovascular events than comparator populations of white European origin. A potential reason for this is reduced nitric oxide bioavailability in African Americans, resulting in increased prevalence of factors that contribute to ventricular dysfunction. We investigated the effects of nebivolol with the diuretic hydrochlorothiazide (HCTZ) in hypertensive African Americans with echocardiographic evidence of diastolic dysfunction. Methods:A total of 42 African American patients were assigned to nebivolol and HCTZ in an open-label fashion for a 24-week period. Changes in blood pressure (BP), echocardiographic parameters, and success in attaining target BP were determined. As an indirect determinant of endothelial function, serum total nitric oxide (NOx) levels and asymmetric dimethyl arginine (ADMA) levels were performed at baseline and after the treatment period. Results:The systolic BP decreased from 150 ± 13 to 136 ± 16 mm Hg (P < .005). Diastolic BP decreased from 94 ± 13 to 84 ± 9 mm Hg (P = .008). Of the patients that completed the study, 77% achieved a combined target BP of systolic BP
ISSN:1074-2484
1940-4034
DOI:10.1177/1074248412436607