Effect of β-blockers on peripheral skin microcirculation in hypertension and peripheral vascular disease

Ubbink, Dirk T.; Verhaar, Emma E; Lie, Henk K.I; Legemate, Dink A.

doi:10.1016/s0741-5214(03)00419-1

Cited by 25 publications

(13 citation statements)

References 27 publications

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“…25,26 The ␤-blocker nebivolol possesses unique vasodilating, endothelium-dependent, NO-releasing properties, which might be particularly beneficial in patients with PAD, because an impaired reactivity of the vascular endothelium has been associated with adverse outcome in patients with this condition. 26 -29 The issue of the impact of ␤-blockers in PAD has been addressed by few trials, mostly with a small sample size and often only short treatment periods, [13][14][15][16][17][18][19][20][21] and studies comparing ␤-blockers with and without vasodilating effects using a double-blind randomized design are lacking.…”

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confidence: 99%

β-Blockers in Patients With Intermittent Claudication and Arterial Hypertension

et al. 2011

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Abstract-The use of ␤-receptor blockers in peripheral arterial disease is controversial for their impact on vasomotor tone.The ␤-blocker nebivolol possesses vasodilating, endothelium-dependent, NO-releasing properties that might be beneficial in peripheral arterial disease. The aim of the study was to evaluate the effects and tolerability of nebivolol in comparison with metoprolol in these patients. A total of 128 patients with intermittent claudication and essential hypertension were included and double-blind randomized to receive 5 mg of nebivolol (Nϭ65) or 95 mg of metoprolol (Nϭ63) once daily. End points were changes in ankle-brachial index, initial and absolute claudication distance, endothelial function assessed by flow-mediated dilatation of the brachial artery, blood pressure, and quality of life using the claudication scale questionnaire. End point analysis was possible in 109 patients (85.2%). After the 48-week treatment period, ankle-brachial index and absolute claudication distance improved significantly in both patient groups (PϽ0.05 for both), with no difference across treatments. A significant increase of initial claudication distance was found in the nebivolol group. Adjusted mean change of initial claudication distance was 33.9% after nebivolol (Pϭ0.003) and 16.6% after metoprolol (Pϭ0.12) treatment. Quality of life was not influenced by either treatment, and there was no relevant change in flow-mediated dilatation in patients treated with nebivolol or metoprolol (Pϭ0.16). Both drugs were equally effective in lowering blood pressure. In conclusion, ␤-blocker therapy was well tolerated in patients with intermittent claudication and arterial hypertension during a treatment period of Ϸ1 year. In the direct comparison, there was no significant difference between nebivolol and metoprolol. (Hypertension. 2011;58:148-154.)

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confidence: 99%

β-Blockers in Patients With Intermittent Claudication and Arterial Hypertension

et al. 2011

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“…14 Studies performed with the use of the laser Doppler flowmetry in other than penile regions of skin also showed minor, or even none, effect of b-blockers on the microcirculation. [40][41][42][43] From drugs used in the current study it was nebivolol that had the least influence on the rabbits' sexual behavior. Nevertheless, its potential minor impact on sexual behavior in our study should be interpreted with caution because due to its pharmacokinetic properties (very long half-life time) 1 it was used (as it is used in human therapy) at a lesser dose than propranolol or metoprolol.…”

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confidence: 84%

The Influence of prolonged β-blockers treatment on male rabbit's sexual behavior and penile microcirculation

et al. 2006

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The aim of the study was to assess the effect of the prolonged intake of three b-blocking drugs (propranolol, metoprolol and nebivolol) on the sexual behavior and penile microcirculation of rabbits. Drugs were administered p.o. for 9 weeks and every three weeks in each group (n ¼ 13) one subgroup (n ¼ 7) performed behavioral tests, whereas in the second subgroup (n ¼ 6) penile microcirculation was measured with a laser Doppler flowmeter. The copulation studies revealed significant impairment of sexual function only in the propranolol treated group. The measured behavioral parameters suggest that at a given dose propranolol affects more performance rather than arousal aspects of rabbits' sexual behavior. In the course of the whole study no significant difference was observed among groups in penile blood flow. The data indicate that among the b-blockers given only propranolol interferes with sexual behavior, and that b-blockers do not appear to have a negative effect on penile microcirculation.

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“…However, multiple studies have not substantiated this fear. Many studies of circulation in patients with peripheral vascular disease and claudication have been conducted, and there is no evidence that β-blockers, selective or nonselective, increase the symptoms of claudication [7,8]. In fact, multiple studies have supported the use of β-blockers in patients undergoing vascular surgery [9], have found no adverse effects of β-blockade in large studies of prevention of PAD in those with diabetes [10], and have found overall improvement in survival in patients PAD in conjunction with statins and angiotensin-converting enzyme inhibitors [11].…”

Section: Peripheral Arterial Diseasementioning

confidence: 99%

Beta-blocker contraindications: Are there patients or situations where use is inappropriate?

Naik¹,

Freudenberger²

2007

Curr Heart Fail Rep

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beta-blockers have been conclusively proven to increase survival and improve symptoms of heart failure, yet there is underutilization of these agents most commonly because of misunderstandings of the relative contraindications and adverse events during treatment. In this manuscript, we discuss the potential contraindications to beta-blockers in heart failure and compare the true risks against the significant benefits.

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Effect of β-blockers on peripheral skin microcirculation in hypertension and peripheral vascular disease

Abstract: beta-Blockers do not appear to have a negative effect on peripheral skin microcirculation and are therefore not contraindicated to treat hypertension when intermittent claudication or ischemic rest pain is also present.

Cited by 25 publications

References 27 publications

β-Blockers in Patients With Intermittent Claudication and Arterial Hypertension

β-Blockers in Patients With Intermittent Claudication and Arterial Hypertension

The Influence of prolonged β-blockers treatment on male rabbit's sexual behavior and penile microcirculation

Beta-blocker contraindications: Are there patients or situations where use is inappropriate?

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