The curious case of Nebivolol - Lower Resting Heart Rate

I have chronic hypertension. Being a thirty year old (ish) male, I’ve used various tools to combat my hypertension; diet, exercise, supplements and pharmacology medications.

I am currently using Telmisartan/Amlodipine as well as a beta blocker known as Nebivolol (Bystolic).

Nebivolol has seemed to make the largest difference in my blood pressure, taking it from an average of 130/90 down to 115/70 in just two months. However, my doctor and I noted a curious benefit to Nebivolol - a dramatically lower resting heart rate.

My resting heart rate prior to Nebivolol was 95-100BPM, I was practically tachycardic. However, after two months my resting heart rate dropped to 65-70BPM without any other modifications.

So I began doing some research into Nebivolol, Beta Blockers and benefits of a low resting heart rate.

A low resting heart rate is often indicative of good physical health, especially cardiovascular health. It suggests that your heart is efficiently pumping blood throughout your body, reducing strain on the heart organ itself. Here are several benefits associated with a low resting heart rate when considering longevity:

  1. Better Heart Health; A lower heart rate usually means your heart muscle is in better condition and doesn’t have to work as hard to manage a beat. It is strong and efficient in its job.

  2. Lower Risk of Cardiovascular Disease; When your heart doesn’t have to work as hard, you are less likely to develop cardiovascular diseases including heart attack and stroke.

  3. Longer Lifespan; Several studies have connected a low resting heart rate with a longer lifespan, due to reduced stress on the cardiovascular system and lower incidence of associated health issues.

  4. Reduced Risk of Sudden Cardiac Death; Studies have suggested that a lower resting heart rate is associated with a reduced risk of sudden cardiac death.

  5. Lower Blood Pressure; Typically, people with lower resting heart rates also have lower blood pressure, another key factor for heart health and longevity.

  6. Better Physical Fitness; A low resting heart rate is often associated with high fitness levels. Physical fitness positively contributes to longevity.

The added benefit of Nebivolol vs other beta blockers is that Nebivolol is a highly selective beta-blocker meaning it only acts on two kinds of beta receptors, which means less side effects that are associated with other beta blockers.

Due to its largely benign side effect profile and huge reward profile I will be keeping it in my longevity stack.

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Really interesting. Thanks for posting this. I’ve seen research in the past on the idea of beta blockers helping with longevity / lifespan. Off the top of my head I’m not sure if the ITP has tested any beta blockers. Here is some of what I’ve seen:

We propose that instituting beta receptor blockade pharmacotherapy at an early age will increase longevity by countering the adverse effects of sympathetically mediated stress.

Blagosklonny has mentioned the lifespan research on Nebivolol:

Beta-blockers

Beta-blockers are widely used to treat hypertension and heart diseases. Propranolol, a non-selective beta-adrenergic blocker, prevents cancer [203-206] and hepatic steatosis [207]. Propranolol is used out-of-label to decrease anxiety. Metoprolol and nebivolol increase the mean and median life span of male mice, by 10% and 6.4% and extend Drosophila life span [208].

Source: | Oncotarget

Blagosklonny also included a beta blocker in his list:

Koschei the immortal and anti-aging drugs

https://www.nature.com/articles/cddis2014520

and also in this paper:

Combinations of conventional drugs

Combinations of aspirin, statins, beta-blockers and ACE inhibitors are given to aging individuals to prevent cardiovascular diseases [135]. On the other hand, these drugs extend life span in rodents and Drosophila [136].

Typical combinations (polypill) include an antiplatelet agent (aspirin), a statin and two blood pressure-lowering drugs such as lisinopril and a beta-blocker [137,138]. Such combinations are estimated to reduce the 5-year incidence of stroke by 50% [139]. Aspirin, statins, ACE inhibitors, beta-blockers and metformin prevent some types of cancer and pre-cancerous polyps [116118,140146].

Source: Disease or not, aging is easily treatable | Aging

There was a recent report that the hypertension drug rilmenidine looks like it may increase lifespan: Rilmenidine Extends Lifespan and Healthspan by 20%

I saw this on Quora, and it makes me wonder about the side effect of impacting your ability to get the benefits of a high heart rate during exercise…

For endurance athletes the reduction in resting heart rate is due to a slightly larger heart allowing a greater stroke volume, so the heart doesn’t need to beat as fast to produce the same stroke volume, which is probably a boon to the athlete’s life span.

Taking a beta-blocker has drawbacks in the ability to exercise, respond to emergencies and sometimes psychological depression among other problems.

Source: https://www.quora.com/If-a-slower-heart-rate-improves-life-expectancy-does-that-mean-beta-blockers-like-Bisoprolol-which-slows-heart-rate-could-increase-life-expectancy

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I take metformin and have recently added nebivolol to my stack. I figure since my exercising ability (vO2max) is already compromised by metformin, nebivolol can’t do much more damage.

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Your doctor just discovered it? He should have expected it. Beta blockers are indicated for tachycardia.

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I meant that it was a welcomed benefit alongside its BP lowering abilities.

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I take carvedilol and my RHR is usually in the 65-70 range. But it was never as high as 95-100. I wonder if nebivolol would cause it to drop lower than carvedilol.

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Nebivolol

By Shivani Priyadarshni; Bryan H. Curry.

Last Update: January 8, 2023

Continuing Education Activity

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I sometimes take another beta blocker Propranolol for headaches (it is prescribed off label for that) but what I notice is not that it lowers only RHR it lowers also maximum heart rate which makes it difficult to track and train at max. heart rate. My RHR is in the mid fifties and when I take Propranolol it is in lower fifties but max. heart rate drops from 179/180 to 158/159, impossible to go higher and that might be a day after I take it so I am wondering if that also diminishes the benefits of training at max. heart rate? I noticed I started to avoid it for that reason…

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I will have to think and read about this more. What type of diet did you try, did you bring sodium to a very low level? For how long did you exercise, how much, and how often? Have you measured your LDL or apoB levels for cardiovascular risk?

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thomopoulos2015.pdf (749.8 KB)

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Thanks for the response!

Over the last eighteen months I’ve lost 150 LBS. using a GLP-1 (Tirzepatide). As for diet, I follow a mediterranean diet.

I don’t follow a low sodium diet, as low sodium diets have largely been debunked and have been associated with a marketed increase in ASCVD;

I do approximately ninety minutes of Zone Two cardio/day with occasional slips into HIIT. I also weight train three times a week.

ApoB: >90
LDL - >80

In fairness to my stats, I also use Lisdexamphetamine (Vyvanse) daily for ADHD and do TRT for low Testosterone.

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I have noticed a small decrease in my Maximum Heart Rate. I’ll do some research on increased risk factors with a lower maximum heart rate outside of cardio training.

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Really interesting, thank you for sharing much appreciated :star_struck:

I am trying to increase my ‘heart rate variability’.

Doing:

What would be great is if this simple pharmacological intervention could increase HRV?

Autonomic Effects of Nebivolol versus Atenolol in Healthy Subjects | Cardiovascular Drugs and Therapy (springer.com)

These β1 selective adrenergic receptor antagonist seem to increase HRV. My interest is well and truly sparked!!!

Overall, the administration of each β -blocker led to directionally similar increases in the HRV variables, which were most significant following 100 mg atenolol.

:star_struck: :star_struck: :star_struck:

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Yes! Actually they tested it in the 2020 cohort, but I haven’t seen any updates on that batch.

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The most important aspects of nebivolol that distinguish it from older beta-blockers are its vasodilating properties (prevents sexual dysfunction associated with other b-blockers) and the fact that it stimulates B3 receptors (beta 3 agonist) which prevents the negative metabolic effects seen with older beta blockers. It really is an amazing medication that is unfortunately SO under-prescribed because most clinicians are simply ignorant of its advantages over the old b-blockers. It recently went generic, so it’s even more of a shame that it’s still so under-prescribed. I’ve been taking it for hypertension for the past 15 years or so.

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That’s just an assosciation and doesn’t debunk the case for sodium restriction based on causal evidence.
Low sodium diets lower blood pressure, decrease rates of stroke, cardiovascular disease and death. If you are a strong responder it might decrease BP by a lot.

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And yes, its cheap as dirt now… about $2 US per strip of 10 tablets…

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Spindler showed life extension in mice. (This fact was mentioned in several posts above, I’m just adding a direct link to the primary source.)

A different design showed no life extension from atenolol in mice.

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I’ve been on 5mg Nebivolol for five years. Extremely pivotal drug in my lifespan extension protocol for lowering blood pressure and heart rate

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