From the Guidelines
Nebivolol and Sympathetic Outflow Activation
Nebivolol can reduce sympathetic outflow activation, thereby alleviating sympathicotonia.
- It is a beta-1-selective blocker that can help alleviate sympathicotonia by inhibiting the effects of the sympathetic nervous system 1.
- The mechanism of nebivolol's effect on the sympathetic nervous system is partly due to its ability to block beta-1-receptors, which can lead to a decrease in sympathetic activation 1.
- This can be beneficial for patients with sympathicotonia, as it can help reduce the deleterious effects of long-term activation of the sympathetic nervous system, such as increased ventricular volumes and pressure, cardiac hypertrophy, and arrhythmias 1.
- Cardioselective beta blockers, including nebivolol, can be used to treat resting tachycardia associated with cardiovascular autonomic neuropathy (CAN) and may increase heart rate variability (HRV) in diabetic patients 1.
From the FDA Drug Label
The mechanism of action of the antihypertensive response of nebivolol tablets has not been definitively established Possible factors that may be involved include: (1) decreased heart rate, (2) decreased myocardial contractility, (3) diminution of tonic sympathetic outflow to the periphery from cerebral vasomotor centers, (4) suppression of renin activity and (5) vasodilation and decreased peripheral vascular resistance.
Nebivolol may reduce sympathetic outflow activation, thereby alleviating sympathicotonia, as one of the possible factors involved in its antihypertensive response is the diminution of tonic sympathetic outflow to the periphery from cerebral vasomotor centers 2 2.
From the Research
Sympathetic Outflow Activation and Nebivolol
- There is limited direct evidence on the effect of Nebivolol on sympathetic outflow activation and alleviating sympathicotonia.
- However, a study on beta-blocking agents, including Nebivolol, found that Nebivolol has a smaller decrease in heart rate compared to atenolol, and does not decrease maximal and endurance exercise capacity 3.
- This suggests that Nebivolol may have a less pronounced effect on sympathetic outflow activation compared to other beta-blockers.
Mechanisms of Sympathetic Activation
- A study on centrally administered lipopolysaccharide found that inflammation activates sympathetic drive through NAD(P)H oxidase-dependent mitogen-activated protein kinase signaling 4.
- This study provides insight into the mechanisms of sympathetic activation, but does not specifically address the effect of Nebivolol on sympathetic outflow activation.
Other Studies
- Studies on folic acid supplementation, resveratrol, and virgin coconut oil have investigated their effects on various physiological and pathological processes, including CNS growth and repair, age-related memory and mood dysfunction, and depression-associated cognitive deficits 5, 6, 7.
- However, these studies do not provide direct evidence on the effect of Nebivolol on sympathetic outflow activation and alleviating sympathicotonia.