Effects of betablockers differents in cardiac alterations of renovascular hypertension

Abstract

Hypertension is a serious clinical condition associated with a high mortality rate, which is often followed by left ventricular hypertrophy (LVH). Extracellular matrix metalloproteinases (MMPs) are the main enzymes that degrade collagen in the ECM. The increase in these proteases, particularly MMP-2 participates in the process of cardiac remodeling in response to hypertension. Oxidative stress is a major factor that may contribute to the increased activity of MMPs, which is one possible mechanism by which reactive oxygen species (ROS) may be involved in the pathophysiology of LVH. Among the drugs recommended for the treatment of LVH in hypertension are the adrenergic blockers. Currently, there are three classes of these drugs, classified according to the selectivity for beta-adrenergic receptors. Nebivolol is considered the most selective receptor ²1adrenergics antagonists, with fewer adverse effects when compared with other beta blockers generations. Some evidences have shown that nebivolol may has vasodilating properties, antioxidant properties and may stimulate the nitric oxide (NO) production, independently of its antagonistic effect receptor ²1. Considering that oxidative stress, endothelial dysfunction and LVH may contribute to the hypertension-induced cardiac dysfunction the nebivolol could attenuate the increase of MMPs, ROS formation and cardiac remodeling associated with hypertension two kidneys and one clip (2K1C), upper than other beta blockers of the second generation, such as metoprolol.