ISSN 2149-2263 | E-ISSN 2149-2271
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Effect of nebivolol and metoprolol treatments on serum asymmetric dimethylarginine levels in hypertensive patients with type 2 diabetes mellitus [Anatol J Cardiol]
Anatol J Cardiol. 2007; 7(4): 383-387

Effect of nebivolol and metoprolol treatments on serum asymmetric dimethylarginine levels in hypertensive patients with type 2 diabetes mellitus

Aytekin Oğuz1, Mehmet Uzunlulu1, Elif Yorulmaz1, Yavuz Yalçın1, Nezih Hekim2, Francesco Fici3
1Department of Internal Medicine, Göztepe Training and Research Hospital, İstanbul
2Pakize Tarzi Laboratory, İstanbul, Turkey
3Excellence Center for Cardiovascular Disease, 2nd University of Naples, Naples, Italy

Objective: Elevated asymmetric dimethylarginine (ADMA) levels, an endogenous inhibitor of nitric oxide synthase, are an important cardiovascular risk factor. In patients with diabetes, increased ADMA levels have been reported, which may be associated with endothelial dysfunction. In this study, effect of nebivolol on serum ADMA levels in hypertensive patients with type 2 diabetes have been compared with metoprolol, an another beta-blocker. Methods: A total of 54 patients (27 female, 27 male; mean age: 53.0±8.7 years) with type 2 diabetes and hypertension were included in this randomized, open-label, prospective study. Patients were randomized to receive either nebivolol 5 mg/day (n=28) or metoprolol 100 mg/day (n=26) for 12 weeks. When the patients could not reach target blood pressure levels at the end of week 4, indapamide (2.5 mg/day) was added. Enzyme Linked Immunosorbent Assay was used for serum ADMA measurements. Results: Similar reductions in blood pressure values were observed in both groups (p>0.05). In nebivolol group, there were no significant changes in serum ADMA levels compared to baseline (0.6±0.2 µmol/l vs 0.6±0.1 µmol/l, p>0.05), whereas in metoprolol group a 35.6% increase in serum ADMA levels was observed (0.6±0.1 µmol/l vs 0.7±0.2 µmol/l, p<0.01). Conclusions: We observed a significant increase in ADMA levels, a marker of endothelial dysfunction, during metoprolol treatment, whereas nebivolol had neutral effects on ADMA levels in patients with type 2 diabetes mellitus and hypertension.

Keywords: Asymmetric dimethylarginine, endothelial dysfunction, diabetes, hypertension, nebivolol, metoprolol

Aytekin Oğuz, Mehmet Uzunlulu, Elif Yorulmaz, Yavuz Yalçın, Nezih Hekim, Francesco Fici. Effect of nebivolol and metoprolol treatments on serum asymmetric dimethylarginine levels in hypertensive patients with type 2 diabetes mellitus. Anatol J Cardiol. 2007; 7(4): 383-387

Corresponding Author: Mehmet Uzunlulu, Türkiye
Manuscript Language: English


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