Skip to main content
SpringerLink
Log in

Once-Daily Nebivolol 5mg Does Not Reduce Airway Patency in Patients with Chronic Obstructive Pulmonary Disease and Arterial Hypertension

A Placebo-Controlled Crossover Study

  • Original Research Article
  • Published:
Clinical Drug Investigation Aims and scope Submit manuscript

Abstract

Objective: To evaluate the 24-hour time-course of the effects of a single dose of nebivolol 5mg on airway patency in patients with chronic obstructive pulmonary disease (COPD).

Design: Short-term, randomised, double-blind, placebo-controlled, crossover study.

Patients: 12 ex-smokers (five males; mean age 63.8 ± 9.8 years, range 46 to 75 years) with stable COPD [mean baseline forced expiratory volume in 1 second (FEV1) 54.9 ± 11.9%; change in FEV1 after salbutamol 200μg = +6.0 ± 3.8% of baseline value] and WHO stage 1–2 mild to moderate arterial hypertension [mean baseline systolic (SBP) and diastolic (DBP) blood pressure, 150.0 ± 12.1 and 97.9 ± 8.4mm Hg, respectively].

Main outcome measures and results: The measured variables were lung function [vital capacity (VC), FEV1, forced vital capacity (FVC), peak expiratory flow (PEF), maximum mid-expiratory flow (MMEF) and specific airway resistance (SRaw)], SBP/DBP and heart rate at baseline (t0), and at 1 (t1), 3 (t3), 6 (t6), 12 (t12) and 24 (t24) hours after the administration of nebivolol or placebo. Exhaled nitric oxide (e-NO) was also assayed at t0, t6 and t24. ANOVA showed that none of the changes from baseline during either 24-hour monitoring period was significant. In terms of the non-respiratory variables, nebivolol did not significantly improve SBP or DBP, although there was a trend towards a reduction in both: the difference in the change in DBP over time between the two treatments was of borderline significance (ANOVA, p < 0.06). Heart rate remained unchanged during both treatments. No significant changes in e-NO were observed throughout the study between placebo and nebivolol treatment.

Conclusions: Our results suggest that a single efficacious dose of nebivolol does not affect airway patency in hypertensive patients with COPD, and seem to confirm the broad tolerability margin of this drug in patients with COPD.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Table I
Table II

Similar content being viewed by others

References

  1. Tafreshi MJ, Weinacker AB. β-adrenergic blocking agents in bronchospastic diseases: a therapeutic dilemma. Pharmacotherapy 1999; 19: 974–8

    Article  PubMed  CAS  Google Scholar 

  2. Mohammed AF, Hulks G, Thomson NC, et al. Effect of nebivolol, atenolol, and propranolol on airway β-adrenergic responsiveness in normal subject. Clin Drug Invest 1991; 3: 196–8

    Article  Google Scholar 

  3. McNeill RS, Ingram CG. Effect of propranolol on ventilatory function. Am J Cardiol 1966; 18: 473–5

    Article  PubMed  CAS  Google Scholar 

  4. Ryo UY, Townley RG. Comparison of respiratory and cardiovascular effects of isoproterenol, propranolol and practolol in asthmatic and normal subjects. J Allergy Clin Immunol 1976; 57(1): 12–24

    Article  PubMed  CAS  Google Scholar 

  5. Szentivanyi A. The beta adrenergic theory of the atopic abnormality in bronchial asthma. J Allergy 1968; 42: 203–32

    Article  Google Scholar 

  6. Townley RG, McGeady S, Bewtra A. The effect of beta-adrenergic blockade on bronchial sensitivity to acetyl-beta-methacholine in normal and allergic rhinitis subjects. J Allergy Clin Immunol 1976; 57: 358–66

    Article  PubMed  CAS  Google Scholar 

  7. Janssens WJ, Van de Water A, Xhonneux R, et al. Nebivolol is devoid of intrinsic sympathomimetic activity. Eur J Pharmacol 1989; 159(1): 89–95

    Article  PubMed  CAS  Google Scholar 

  8. McNeely W, Goa KL. Nebivolol in the management of essential hypertension: a review. Drugs 1999; 57(4): 633–51

    Article  PubMed  CAS  Google Scholar 

  9. Mangrella M, Rossi F, Fici F, et al. Pharmacology of nebivolol. Pharmacol Res 1998; 38(6): 419–31

    Article  PubMed  CAS  Google Scholar 

  10. Broeders MA, Doevendans PA, Bekkers BC, et al. Nebivolol: a third-generation beta-blocker that augments vascular nitric oxide release: endothelial beta(2)-adrenergic receptor-mediated nitric oxide production. Circulation 2000; 102(6): 677–84

    Article  PubMed  CAS  Google Scholar 

  11. Franciosa JA. Beta-adrenergic blocking agents: past, present and future perspectives. Coron Artery Dis 1999; 10(6): 369–76

    Article  PubMed  CAS  Google Scholar 

  12. Siafakas NM, Vermeire P, Pride NB, et al. Optimal assessment and management of chronic obstructive pulmonary disease (COPD). The European Respiratory Task Force. Eur Respir J 1995; 8(8): 1398–420

    Article  PubMed  CAS  Google Scholar 

  13. Quanjer P. Standardized lung function testing. Bull Eur Physiopathol Respir 1983; 19 Suppl. 5: 7–94

    Google Scholar 

  14. Kharitonov S, Alving K, Barnes PJ. Exhaled and nasal nitric oxide measurements: recommendations. Eur Respir J 1997; 10: 1683–93

    Article  PubMed  CAS  Google Scholar 

  15. Beumer HM. Adverse effects of β-adrenergic receptor blocking drugs on respiratory function. Drugs 1974; 7: 130–8

    Article  PubMed  CAS  Google Scholar 

  16. Lammers JW, Folgering HT, van Herwaarden CL. Ventilatory effects of long-term treatment with pindolol and metoprolol in hypertensive patients with chronic obstructive lung disease. Br J Clin Pharmacol 1985; 20(3): 205–10

    Article  PubMed  CAS  Google Scholar 

  17. Chahuan M, Corradi L, Roman O, et al. Safety and efficacy of celiprolol in hypertensive patients with chronic obstructive lung disease. Rev Med Chil 2000; 128(1): 59–63

    PubMed  CAS  Google Scholar 

  18. Bowman AJ, Chen CPH, Ford GA. Nitric oxide mediated venodilator effects of nebivolol. Br J Clin Pharmacol 1994; 38: 199–204

    Article  PubMed  CAS  Google Scholar 

  19. Gao Y, Nagao T, Bond RA, et al. Nebivolol induces endothelium-dependent relaxations of canine arteries. Clin Drug Invest 1991; 3: 118–9

    Google Scholar 

  20. Cockcroft JR, Chowienczyk PJ, Brett SE, et al. Nebivolol vasodilates human forearm vasculature: evidence of an L-arginine/NO-dependent mechanism. J Pharmacol Exp Ther 1995; 274(3): 1067–71

    PubMed  CAS  Google Scholar 

  21. Silkoff PE, Martin D, Pak J, et al. Exhaled nitric oxide and induced sputum analysis as markers of airway inflammation in subjects with COPD. Chest 2000; 117(5) Suppl. 1: 281S

    Article  PubMed  Google Scholar 

  22. Van Herwaarden CL. Beta-adrenoceptor blockade and pulmonary function in patients suffering from chronic obstructive lung disease. J Cardiovasc Pharmacol 1983; 5(1): S46–50

    Article  PubMed  Google Scholar 

  23. Fogari R, Zoppi A, Tettamanti F, et al. Comparative effects of celiprolol, propranolol, oxprenolol, and atenolol on respiratory function in hypertensive patients with chronic obstructive lung disease. Cardiovasc Drugs Ther 1990; 4(4): 1145–9

    Article  PubMed  CAS  Google Scholar 

  24. Dorow P, Bethge H, Tonnesmann U. Effects of single oral doses of bisoprolol and atenolol on airway function in nonasthmatic chronic obstructive lung disease and angina pectoris. Eur J Clin Pharmacol 1986; 31(2): 143–7

    Article  PubMed  CAS  Google Scholar 

  25. Dorow P. Effect of different beta-receptor blockers on the respiratory function of patients with chronic obstructive pulmonary disease and arterial hypertension. Arzneimittel-forschung 1987; 37(12): 1370–2

    PubMed  CAS  Google Scholar 

  26. Van Zyl AI, Jennings AA, Bateman ED, et al. Comparison of respiratory effects of two cardioselective beta-blockers, celiprolol and atenolol, in asthmatics with mild to moderate hypertension. Chest 1989; 95(1): 209–13

    Article  PubMed  Google Scholar 

  27. Cazzola M, Noschese P, D’Amato M, et al. Comparison of the effects of single oral doses of nebivolol and celiprolol an airways in patients with mild asthma. Chest 2000; 118: 1322–6

    Article  PubMed  CAS  Google Scholar 

  28. Dal Negro RW, Tognella S, Micheletto C. Pharmacokinetics of the effect of nebivolol 5mg on airway patency in patients with mild to moderate bronchial asthma and arterial hypertension. Clin Drug Invest 22 (3): 197–204

Download references

Acknowledgements

This study was partially funded by A. Menarini, Italy.

Author information

Authors and Affiliations

  1. Chest Department, Orlandi General Hospital, Bussolengo, Verona, Italy

    R. W. Dal Negro, S. Tognella & C. Pomari

Authors
  1. R. W. Dal Negro
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. S. Tognella
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. C. Pomari
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to R. W. Dal Negro.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Dal Negro, R.W., Tognella, S. & Pomari, C. Once-Daily Nebivolol 5mg Does Not Reduce Airway Patency in Patients with Chronic Obstructive Pulmonary Disease and Arterial Hypertension. Clin. Drug Investig. 22, 361–367 (2002). https://doi.org/10.2165/00044011-200222060-00003

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.2165/00044011-200222060-00003

Keywords

Search

Navigation