SENIORS Trial: Nebivolol in Elderly HFrEF
European Heart Journal (2005)
Reduced composite of death/CV hospitalization by 14% in 2,128 elderly HFrEF patients.
How it works
Marek's Guided Optimization® Program combines advanced lab testing, a dedicated health coach and medical provider, and a personalized treatment plan, all built around your data.
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The process
1
Start your assessment
Complete your 45-min intake assessment
2
Get your labs drawn
4,000 partnered lab locations nationwide
3
Review with your coach
Screen-by-screen lab review
4
Receive your protocol
Treatment delivered to your door
Why Marek
The only program pairing you with a dedicated health coach and medical provider, built on precision diagnostics, with no subscription required.
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Meet our co-founder
Derek
Co-Founder · MPMD Podcast
"Over time, I found it incredibly difficult to get medical oversight for myself and my family that reflected the latest research, and that was preventative. That's why I started Marek Health."
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What we test
Every client's lab panel is hand-selected from 1,000+ available biomarkers, built around their specific goals.
Panel categories
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Treatments
700+ medical provider-prescribed therapies built from your labs. Browse by category or explore the full formulary.
Nebivolol
Oral tablet (5mg)Available in all 50 statesMarketing purposes only. Actual medications, if prescribed, are dispensed by a licensed pharmacy.
heart
NebivololNebivolol
Third-generation beta-1 selective blocker with unique NO-enhancing mechanism via beta-3 receptor agonism and eNOS stimulation. Metabolically neutral, does not worsen insulin resistance or dyslipidemia unlike older beta-blockers.
Metabolically neutral, no insulin resistance or dyslipidemia worsening
NO-mediated vasodilation improves endothelial function
Less fatigue and ED than older beta-blockers
14% mortality reduction in elderly HFrEF (SENIORS)
No commitment · HSA/FSA eligibleNo commitment · HSA/FSA eligible
How it works
Mechanism of action
Highly selective beta-1 blockade reduces HR and cardiac output. Additionally stimulates beta-3 receptors on endothelial cells, activating eNOS and producing vasodilation via NO pathway. Dual mechanism distinguishes from older beta-blockers.
The baseline panel.
Every Marek client receives this baseline panel before a provider review. Your provider may add additional biomarkers based on your health history, symptoms, and goals, pulling from 1,000+ available markers. See more biomarkers →
Hormone Profile
12 markers
Sex hormones
- Total TestosteroneLC/MS
- Free TestosteroneEquilibrium Dialysis
- Estradiol, Sensitive / UltrasensitiveLC/MS
- Sex Hormone Binding Globulin (SHBG)
- ProgesteroneLC/MSFemale panel
- Prolactin
- Luteinizing Hormone (LH)
- Follicle-Stimulating Hormone (FSH)
- hCG, Total, QuantitativeFemale panel, pre-menopause
Adrenals & neurosteroids
- Cortisol
- DHEA-S
Growth hormone / IGF-1
- Insulin-Like Growth Factor I (IGF-1)
Thyroid Status
3 markers
Thyroid hormones
- Thyroid Stimulating Hormone (TSH)
- Free T4
- Free T3
Heart Health
9 markers
Cardiovascular health
- Total Cholesterol
- HDL Cholesterol
- LDL Cholesterol
- LDL:HDL Ratio
- VLDL Cholesterol
- Triglycerides
- Apolipoprotein-B (ApoB)
- C-Reactive Protein, High Sensitivity (hsCRP)
- Lipoprotein(a) (Lp(a))
Metabolism
3 markers
Insulin sensitivity
- Blood Glucose
- Fasting Insulin
- HbA1c
Organ Function
26 markers
Liver & pancreas
- AST
- ALT
- Bilirubin, Total
- γ-Glutamyl Transferase (GGT)
Kidney function
- BUN
- Creatinine w/ eGFR
Comprehensive Metabolic Panel (CMP)
- Glucose
- Blood Urea Nitrogen (BUN)
- Creatinine
- eGFR
- BUN/Creatinine Ratio
- Sodium
- Potassium
- Chloride
- Carbon Dioxide, Total
- Calcium
- Protein, Total
- Albumin
- Globulin, Total
- Albumin/Globulin (A/G) Ratio
- Alkaline Phosphatase (ALP)
- AST
- ALT
Prostate health
- Prostate-Specific Antigen (PSA)Male panel
- Free PSAMale panel
- % Free PSAMale panel
Nutrient Status
31 markers
Vitamins & minerals
- Vitamin D, 25-OHD (25-Hydroxy)
- Magnesium, RBC
Iron status
- Iron
- Iron Saturation
- TIBC
- UIBC
- Ferritin
Complete Blood Count (CBC)
- White Blood Count (WBC)
- Red Blood Count (RBC)
- Hemoglobin (Hgb)
- Hematocrit (HCT)
- MCV
- MCH
- MCHC
- Red Cell Distribution Width (RDW)
- Platelets
- Neutrophils
- Neutrophils (Absolute)
- Lymphocytes
- Lymphocytes (Absolute)
- Neutrophil/Lymphocyte Ratio
- Monocytes
- Monocytes (Absolute)
- Eosinophils
- Eosinophils (Absolute)
- Basophils
- Basophils (Absolute)
- Immature Cells
- Immature Granulocytes
- Immature Granulocytes (Absolute)
- NRBC, w/ Reflex for Immature Cells
Clinical evidence
The research behind Nebivolol.
Safety profile
Monitoring & safety information.
Commonly reported side effects
- Bradycardia
- Fatigue (less than older beta-blockers)
- Headache
- Dizziness
Less common but serious risks
- Severe bradycardia/heart block
- Bronchospasm (possible)
- Masking hypoglycemia
- Withdrawal syndrome
Generally not appropriate for
- Severe bradycardia (<50 bpm)
- Sick sinus syndrome
- 2nd/3rd degree heart block
- Decompensated HF
- Severe asthma
Typical monitoring
- Heart rate and BP
- ECG at baseline
- Fasting glucose and lipids
- Pulmonary symptoms
FAQ
Quick answers.
Third-generation beta-1 selective blocker with unique NO-enhancing mechanism via beta-3 receptor agonism and eNOS stimulation. Metabolically neutral, does not worsen insulin resistance or dyslipidemia unlike older beta-blockers.
Metabolically neutral, no insulin resistance or dyslipidemia worsening. NO-mediated vasodilation improves endothelial function. Less fatigue and ED than older beta-blockers. 14% mortality reduction in elderly HFrEF (SENIORS).
Common side effects include: bradycardia, fatigue (less than older beta-blockers), headache, dizziness. Most side effects are dose-dependent and may resolve with continued use or dose adjustment.
Third-generation beta-1 selective blocker with unique NO-enhancing mechanism via beta-3 receptor agonism and eNOS stimulation. Metabolically neutral, does not worsen insulin resistance or dyslipidemia unlike older beta-blockers.
Treatments are dependent on licensed clinical prescription. Client costs vary based on individual labs and panel in treatments and services.