Differential effects of nebivolol and metoprolol on arterial stiffness, circulating progenitor cells, and oxidative stress

• Beta–blocker therapy is associated with an increase in circulating progenitor cells
• Nebivolol did not improve aminothiol markers of oxidative stress
• Nebivolol improved arterial stiffness only in beta–blocker naïve subjects

Unlike traditional beta receptor antagonists, nebivolol activates nitric oxide. We hypothesized that therapy with nebivolol compared with metoprolol would improve arterial stiffness, increase levels of circulating progenitor cells (PC), and decrease oxidative stress (OS). In a randomized, double–blind, cross–over study, 30 hypertensive subjects received either once daily nebivolol or metoprolol succinate for 3 months each. Pulse wave velocity and augmentation index were measured using tonometry. Flow cytometry was used to measure circulating PC. OS was measured as plasma aminothiols. Measurements were performed at baseline, and repeated at 3 and 6 months. No significant differences were present between the levels of OS, arterial stiffness, and PC numbers during treatment with metoprolol compared with nebivolol. In subgroup analyses of beta–blocker naïve subjects (n = 19), nebivolol reduced pulse wave velocity significantly compared with metoprolol (−1.4 ± 1.9 vs. −0.1 ± 2.2; P = .005). Both nebivolol and metoprolol increased circulating levels of CD34+/CD133 + PC similarly (P = .05), suggesting improved regenerative capacity.