Effects of Cardioselective Beta Blocker Nebivolol on Different Biochemical Parameters in Essential Hypertensive Patients.

Background : Nebivolol is a third-generation highly selective b1-blocker with additional endothelial nitric oxide (NO) mediated vasodilating activity. This property may potentiate the blood pressure-lowering effect of Nebivolol. Nebivolol is also claimed to have neutral or favourable effect on carbohydrate metabolism and lipid profile. Therefore this study was conducted to evaluate effects of Nebivolol on different biochemical parameters in essential hypertensive patients. Materials and Methods : 21 newly diagnosed patients of either sex with essential hypertension were included in the study. Patients having co-morbidities e.g. Diabetes mellitus, hyperlipidemia, gout, pregnant females were excluded from the study. Baseline readings of lipid profile, serum electrolytes, fasting blood sugar and uric acid were recorded before starting Nebivolol drug therapy. Same biochemical tests were repeated after six months drug treatment. Results and Observation : After comparing the means there is increase in total cholesterol, LDL, Serum electrolytes, blood sugar levels but this increase is within normal limits and is not statistically significant. While there is decrease in TG level but statistically not significant. No significant change in HDL, uric acid levels. Conclusion : Nebivolol is a unique, highly selective b1-blocker due to its neutral metabolic properties and is potentially safe over conventional b-blockers.

Hypertension: Salt restriction, sodium homeostasis, and other ions.

Salt is composed of Sodium Chloride (NaCl) which in body water becomes essential electrolytes, viz., Sodium (Na + ) and Chloride (Cl - ) ions, including in the blood and other extracellular fluids (ECF). Na + ions are necessary cations in muscle contractions and their depletion will effect all the muscles in body including smooth muscle contraction of blood vessels, a fact which is utilized in lowering the blood pressure. Na+ ions also hold water with them in the ECF. Na + homeostasis in body is maintained by thirst (water intake), kidneys (urinary excretion) and skin (sweating). In Na + withdrawal, body tries to maintain homeostasis as far as possible. However, in certain conditions (e.g., during exercise, intake of drugs and in disorders causing Syndrome of Inappropriate Anti Diuretic Hormone Secretion (SIADH), diuretics, diarrhea) coupled with moderate or severe dietary salt restriction (anorexia nervosa), hyponatremia can get precipitated. Hyponatremia is one end point in the spectrum of disorders caused by severe Na + depletion whereas in moderate depletion it can cause hypohydration (or less total body water) and lower urinary volume (U v ). Moreover, salt sensitivity varies in various populations leading to different responses in relation to dietary Na + intake. Diabetes and Hypertension often co-exist but Na + withdrawal in salt sensitive subjects worsens diabetes though hypertension gets better and reverse occurs in salt loading. Therefore, Na + or salt restriction may be non-physiological. In hypertensive subjects other alternatives to Na + withdrawal could be Potassium (K + ) and Calcium (Ca 2+ ) supplementation. Further studies are required to monitor safety/side effects of salt restriction.