Hypertension is the most prevalent cardiovascular disease in the world. Because of associated morbidity and mortality it is in one of the most important public health problems. Hypertension is the most important cause of heart failure with low or preserved ejection fraction. If hypertension develops concomitant with diabetes mellitus treatment problem of the two diseases becomes more complex. It is known that beta-blockers may induce type 2 diabetes, but those of new generation such as Nebivolol do not have this effect.
There are many drugs with proven efficacy in lowering blood pressure, but the optimal treatment to prevent progression to heart failure is uncertain. Beta-blockers are a class of drugs with benefits both on hypertension and in heart failure. Drugs of this class have different pharmacological properties in terms hemodynamic and cardiovascular.
Nebivolol is a beta-blocker that causes vasodilatation mediated by nitric oxide release. This medicine lowers blood pressure, prevents endothelial dysfunction and improves coronary flow reserve and diastolic function independent of ventricular geometry changes. Action of nebivolol is superior to classic beta blockers by reversibility of subclinical changes in the left ventricle before the onset of heart failure.
In the early stages of heart failure with preserved ejection fraction the management is not yet established. Therefore it is important to know that in these situations nebivolol has beneficial effects.