Does nebivolol improve wave reflection and arterial stiffness compared to atenolol in patients with hypertension?
Nebivolol has distinct hemodynamic effects on small muscular arteries compared to atenolol, indicating that beta-blockers should not be considered a homogeneous class in hypertension management.
The beta-blockers, atenolol and nebivolol, have a similar effect in reducing arterial stiffness in the large elastic aorta, largely secondary to BP reduction. Nebivolol, in contrast to atenolol, has an effect on small muscular arteries, increasing PP amplification and reducing wave reflection, possibly because of increased levels of nitric oxide (NO). Such ancillary properties may impart important distinct hemodynamic effects, and therefore beta-blockers cannot be regarded as a homogeneous group.
Mahmud et al. (Mon,) studied this question.