Prospective follow-up of nebivolol in the treatment of arterial hypertension

Abstract

Introduction. Nebivolol, a third-generation beta-blocker (BB) shows a highly selective beta-blockade and specific vasodilating effects due to getting free nitro-oxide from the dysfunctional endothelium. Objective. The aim of the study was to investigate the antihypertensive effect of nebivolol in patients with arterial hypertension (AH) of both sexes. Methods. Systolic and diastolic blood pressure (BP), heart rate and serum glycemia, creatinin, cholesterol and trygliceride were measured after a 6-week treatment with a single 5 mg dose of nebivolol once daily so as to assess its efficacy and metabolic effects, as well as its tolerance by using a questionnaire answered by physicians and patients. Results. Out of 520 patients with mild or moderate AH, 430 (82.7%) were treated with nebivolol as monotherapy. After a 6-week treatment with nebivolol, with very good tolerability and neutral metabolic effects, systolic BP was significantly decreased (in male from initial 165?19 to 129?12 mm Hg, and female from initial 169?22 to 132?15 mm Hg at the end of the study; average decrease 22.3%, p<0.001) and as well as diastolic BP (male from initial 103?12 to 79?6 mm Hg and female from initial 100?9 to 82?7 mm Hg, average decrease 22.6%; p<0.001). Conclusion. After a 6-week treatment nebivolol significantly decreased systolic and diastolic BP in patients with mild and moderate AH, independently of the sex.Uvod. Nebivolol, beta- bloker trece generacije, zasniva svoj antihipertenzivni efekat na veoma selektivnoj beta-blokerskoj aktivnosti i specificnoj vazodilatatornoj aktivnosti u cijoj je osnovi oslobadjanje azot-monoksida. Cilj rada. Cilj istrazivanja bio je da se proceni antihipertenzivni efekat nebivolola kod ispitanika s arterijskom hipertenzijom. Metode rada. Nakon sestonedeljne primene nebivolola (5 mg jednom dnevno) vrsila se procena njegove efikasnosti (merenjem sistolnog i dijastolnog krvnog pritiska), tolerabilnosti (kroz anketu koju su popunjavali i lekari i ispitanici) i njegovog uticaja na metabolicke efekte (na glikemiju, nivo kreatinina, holesterola i triglicerida). Rezultati. Od ukupno 520 ispitanika sa blagom ili umerenom arterijskom hipertenzijom, 430 bolesnika (82,7%) leceno je samo nebivololom (monoterapija). Nakon sest nedelja primene ovoga leka, uz odlicnu tolerabilnost i neutralne metabolicke efekte, znacajno su se smanjili i sistolni i dijastolni krvni pritisak. Sistolni krvni pritisak se kod muskaraca smanjio sa 165?19 na 129?12 mm Hg, a kod zena sa 169?22 na 132?15 mm Hg (prosecno smanjenje bilo je 22,3%; p<0,001), dok se dijastolni krvni pritisak kod muskaraca smanjio sa 103?12 na 79?6 mm Hg, a kod zena sa 100?9 na 82?7 mm Hg (prosecno smanjenje bilo je 22,6%; p<0,001). Zakljucak. Primena nebivolola kod osoba sa blagom i umerenom arterijskom hipertenzijom dovodi do znacajnog smanjenja kako sistolnog, tako i dijastolnog krvnog pritiska, nezavisno od pola.