The Effect of Nebivolol on Office Blood Pressure of Blacks Residing in Sub-Saharan Africa (A Pilot Study)

Abstract

Introduction: There is substantial clinical evidence that monotherapy with beta-blockers are less effective in reducing blood pressure among hypertensive Black patients compared to Whites. The highly selective beta-1 agents like nebivolol and bisoprolol have, however, been reported to be effective in reducing blood pressure in African Americans. However, results in African Americans cannot be extrapolated to native Africans because of genetic admixture and gene-environment interaction. There is, therefore, the need for us to generate data that are applicable to Africans residing in sub-Saharan Africa. We therefore decided to evaluate the efficacy and tolerability of highly selective beta-1 agent nebivolol in hypertensive Black patients residing in sub-Saharan Africa.Materials and Methods: The nebivolol study was a multicenter, prospective, observational program among hypertensive patients with 4- and 8-week follow up which was conducted in 5 cities in Nigeria of Abuja, Calabar, Enugu, Oghara, and Port Harcourt. Dosages of nebivolol used in keeping with local prescribing information were 5 and 10 mg once daily each. The effectiveness of treatment was assessed by change from baseline in mean office systolic and diastolic blood pressures, and the proportion of patients achieving the therapeutic goal of <140/90 mmHg. Safety and tolerability of this medication were also assessed.Results: We report the results of the 140 patients studied. The mean age and body mass index were 46.9 ± 7.3 years and 22.3 ± 5.8 kg/m2, respectively, and 57.1% were female. Nebivolol reduced SBP and DBP by 7.6 and 6.6 mmHg, respectively, in 4 weeks, and by 11.1 and 8.0 mm Hg, respectively, in 8 weeks. Blood pressure control was achieved in 54.8% of the patients in 4 weeks and increased to 60.4% in 8 weeks. There was no change in metabolic profile between randomization and at 8 weeks, and erectile dysfunction occurred in 1.3% of the study population.Conclusions: Nebivolol 5 and 10 mg appear efficacious in Nigerian Africans with no negative metabolic effect and minimal side effect profile.Clinical Trial Registration:www.ClinicalTrials.gov, Study Identification: NCT 03598673.

Beta adrenergic antagonists and antianginal drugs

“…The reported incidence of erectile dysfunction (ED) in this study exceeds the previously reported incidence of <1% per nebivolol prescribing information. Follow-up research should be done to determine if beta blocker induced ED is more prevalent than in previous research, or if the patient population studied (Sub-Saharan Africans) are at an increased risk of this side effect (Ojji et al, 2020) [C].…”

In vivo Study of the Effect of 5 and 10% Nebivolol Cream on Hair Growth in Mice Models

“…2 It is known that nitric oxide (NO) causes greater arterial distension and greater blood supply as being an endotheliumdependent acute vasodilator 3 that can also increase the RESEARCH ARTICLE expression of vascular endothelial growth factor (VEGF) 4 which is an autocrine growth factor for dermal papillae cells and key angiogenesis promoting factor that causes an increase in the peri-follicular vascularization and in the vascular permeability leading to an increase in hair follicle size and hair shaft length, (VEGF) mRNA is strongly expressed in the keratinocytes of the outer root sheath of hair follicles during early and mid-anagen (active growth) and regress during catagen (regression) and telogen (resting) phases. 5,6 Nebivolol is a long-acting, third-generation and highly selective beta-1 (β1) adrenergic receptor blocker 7 that causes direct vasodilation via causing an increase in NO in the L-arginine-NO pathway by stimulating the endothelial nitric oxide synthase (eNOS) mediated via its β3 receptor agonistic effect, 8 furthermore nebivolol also exhibits antioxidant 9 and anti-inflammatory effects. 10 The improvement of perifollicular microcirculation is well known to play important role in the induction of hair growth and in causing hypertrichosis.…”