The Effect of Nebivolol in Hypertensive Patients With Coronary Arterial Spasm
Status:
Completed
Trial end date:
2019-03-31
Target enrollment:
Participant gender:
Summary
The correlation between endothelial dysfunction and the risk of coronary heart disease is
well known through previous studies. The degradation of the function of nitric oxide acting
on the endothelium of blood vessels is mainly explained by reduction of synthesis, loss due
to oxidative stress, and decreased sensitivity to vascular dilatation action. In particular,
patients with high blood pressure have been known to have impaired vascular endothelial
function through animal experiments and several clinical studies, mainly due to increased
biomechanical friction in the blood vessels and decreased biological availability of nitric
oxide, which in turn causes incongruity in the production of nitric monoxide and changes in
normal vascular dilatation. There have also been reports recently that early diagnosis and
treatment may improve endothelial dysfunction and prevent the progression of coronary artery
disease. However, the reality is that the drugs available in vasospastic angina patients with
endothelial dysfunction are very limited. Until recently, beta-blockers were reported to
inhibit vascular dilatation of adrenaline stimuli, a drug corresponding to relative
contraindications in vasospastic angina patients, with one study reporting that propranolol
cannot, but rather exacerbates, vasospastic angina. However, a series of reports on the
vascular dilatation of the recently developed third-generation beta-blockers have reinvented
the role of beta-blockers in vasospastic angina, especially nebivolol (selective, continuous
beta-blockers) is known to act on β-1 adrenaline receptor blockings and endothelium to create
vascular dilatation, and also to stimulate β-3 adrenaline receptors to cause nitric oxide
generation and antioxidant effects in the endothelium of blood vessels. Therefore, this
clinical trial seeks to find whether nebivolol will inhibit vascular contraction in
hypertensive patients and will work in angiospastic angina patients.
Phase:
Phase 4
Details
Lead Sponsor:
Korea University Anam Hospital
Collaborators:
Korea University Guro Hospital Korea Unversity Ansan Hospital Severance Hospital