Universidad de Buenos Aires, Facultad de Farmacia y Bioquímica, Departamento de Farmacología.
Universidad de Buenos Aires, Facultad de Farmacia y Bioquímica, Cátedra de Físicoquímica, Instituto de Bioquímica y Medicina Molecular (IBIMOL).
J Hypertens. 2020 Mar;38(3):536-545. doi: 10.1097/HJH.0000000000002284.
β-blockers are no longer considered as first-line antihypertensive drugs due to their lower cardioprotection.
Considering the differences in the pharmacological properties of β-blockers, the present work compared the effects of third-generation β-blockers - carvedilol and nebivolol - with a first-line agent - amlodipine - on hemodynamic parameters, including short-term blood pressure variability (BPV), and their ability to prevent target organ damage in spontaneously hypertensive rats (SHR). SHR rats were orally treated with carvedilol, nebivolol, atenolol, amlodipine or vehicle for 8 weeks. Wistar Kyoto rats treated with vehicle were used as normotensive group. Echocardiographic evaluation, BP, and short-term BPV measurements were performed. Left ventricle and thoracic aorta were removed for histological evaluations and to assess the expression of transforming growth factor β (TGF-β), tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6).
Carvedilol, nebivolol or amlodipine induced a greater reduction of carotid BP, short-term BPV and echocardiography parameters than atenolol in SHR rats. Carvedilol, nebivolol and amlodipine were more effective than atenolol in the prevention of cardiac hypertrophy, and cardiac and aortic collagen deposit. Carvedilol and nebivolol, but not atenolol, reduced the expressions of fibrotic and inflammatory biomarkers - TGF-β, TNF-α and IL-6 - in SHR rats to a similar extent to that of amlodipine.
Chronic treatment with carvedilol or nebivolol attenuates carotid BP and short-term BPV, and reduces target organ damage in SHR to a greater extent than atenolol. Our findings suggest that the lower cardiovascular protection of nonvasodilating β-blockers, as atenolol, in hypertension must not be translated to third-generation β-blockers.
由于β受体阻滞剂的心脏保护作用较低,因此不再被视为一线降压药物。
考虑到β受体阻滞剂的药理学特性存在差异,本研究比较了第三代β受体阻滞剂卡维地洛和比索洛尔与一线药物氨氯地平对血流动力学参数(包括短期血压变异性(BPV))的影响,以及它们预防自发性高血压大鼠(SHR)靶器官损伤的能力。SHR 大鼠口服给予卡维地洛、比索洛尔、阿替洛尔、氨氯地平或载体 8 周。给予载体的 Wistar Kyoto 大鼠用作正常血压组。进行超声心动图评估、血压和短期 BPV 测量。取出左心室和胸主动脉进行组织学评估,并评估转化生长因子β(TGF-β)、肿瘤坏死因子-α(TNF-α)和白细胞介素-6(IL-6)的表达。
与阿替洛尔相比,卡维地洛、比索洛尔或氨氯地平在 SHR 大鼠中更能降低颈动脉血压、短期 BPV 和超声心动图参数。卡维地洛、比索洛尔和氨氯地平在预防心脏肥大以及心脏和主动脉胶原沉积方面比阿替洛尔更有效。卡维地洛和比索洛尔,而不是阿替洛尔,可降低 SHR 大鼠中纤维化和炎症生物标志物 TGF-β、TNF-α 和 IL-6 的表达,其程度与氨氯地平相似。
慢性给予卡维地洛或比索洛尔可减轻 SHR 大鼠的颈动脉血压和短期 BPV,并在更大程度上减轻目标器官损伤,其效果优于阿替洛尔。我们的研究结果表明,非血管扩张性β受体阻滞剂(如阿替洛尔)在高血压中的心血管保护作用较低,不能转化为第三代β受体阻滞剂。