Comparative effects of a new cardioselective beta-blocker nebivolol and nifedipine sustained-release on 24-hour ambulatory blood pressure and plasma lipoproteins.
This double-blind, parallel-group study compared the effects of nebivolol, a novel cardioselective beta-blocker, with those of nifedipine sustained-release on 24-hour ambulatory blood pressure and plasma lipoprotein levels. After a washout period of 8 weeks, 51 patients with mild to moderate essential hypertension were randomized to double-blind treatment with either nebivolol 5 mg once a day (n = 26) or nifedipine sustained-release 20 mg bid (n = 25) over a period of 12 weeks. Both treatments produced similar and significant (P = .0001) reduction in office blood pressure as well as in 24-hour, work, awake, and sleep ambulatory blood pressure. The clinical response (diastolic blood pressure less than 90 mmHg or decreased by greater than or equal to 10 mmHg) rate was 69% for nebivolol and 59% for nifedipine, respectively. Moreover, the nebivolol and nifedipine treatment-induced decreases in mean 24-hour ambulatory blood pressure were similar to the decreases in clinic blood pressure. Furthermore, the percentages of "blood pressure loads" (awake greater than 140/90 mmHg and asleep greater than 120/80 mmHg) were lowered significantly (P = .0001), from 60% to 29% with nebivolol and from 60% to 39% with nifedipine. Mean ambulatory heart rate was reduced (P = .0001) from 79 +/- 7 to 68 +/- 7 beats/minute during nebivolol therapy and from 80 +/- 9 to 79 +/- 7 (not significant) with nifedipine. Total plasma cholesterol and low-density lipoprotein levels decreased significantly (P less than .05) by 5 and 8%, respectively, after nebivolol treatment, and each decreased by 3% after nifedipine treatment.(ABSTRACT TRUNCATED AT 250 WORDS)
Lacourcière
Y
Y
Hypertension Unit, Centre Hospitalier Université Laval, Québec, Canada.
Poirier
L
L
Lefebvre
J
J
Provencher
P
P
Arnott
W
W
D000293:Adolescent; D000319:Adrenergic beta-Antagonists / Q000494:pharmacology*; D000328:Adult; D000368:Aged; D000553:Ambulatory Care; D001578:Benzopyrans / Q000494:pharmacology*; D001794:Blood Pressure / Q000187:drug effects*; D001795:Blood Pressure Determination; D003692:Delayed-Action Preparations; D004311:Double-Blind Method; D004983:Ethanolamines / Q000494:pharmacology*; D005260:Female; D006339:Heart Rate / Q000187:drug effects*; D006801:Humans; D008074:Lipoproteins / Q000097:blood / Q000187:drug effects*; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic; D000068577:Nebivolol; D009543:Nifedipine / Q000008:administration & dosage / Q000494:pharmacology*; D013997:Time Factors
D000319:Adrenergic beta-Antagonists; D001578:Benzopyrans; D003692:Delayed-Action Preparations; D004983:Ethanolamines; D008074:Lipoproteins; D000068577:Nebivolol; D009543:Nifedipine