Influence of nebivolol on the cardiovascular hemodynamics during postural changes and isometric exercise

Nebivolol (R67555), a drug with beta₁ receptor antagonizing properties, was administered once daily (5 mg) for 7 days in 10 healthy volunteers. The hemodynamic parameters were measured noninvasively during postural changes (supine, sitting, standing) and during isometric handgrip at 50% maximal voluntary contraction, before and 3, 8, and 23 hours after the first nebivolol intake of 5 mg; the same measurements were done 23 hours after the last intake. Nebivolol lowered arterial blood pressure acutely and chronically due to a decrease in heart rate and cardiac output. The stroke volume seemed to be preserved, while the total peripheral vascular resistance did not change. Nebivolol did not change the orthostatic responses, except that the absolute value was lowered. Nebivolol was unable to prevent the blood pressure increase during isometric handgrip. However, this blood pressure increase was obtained by an increase in the total peripheral vascular resistance and not by an increase in the cardiac output, as observed during control measurements before nebivolol intake.