Determination of the anti-ischemic activity of nebivolol in comparison with atenolol.
The anti-ischemic effect of 5 mg nebivolol o.i.d., a newly developed beta 1-selective adrenoceptor blocking drug with vasodilating properties, was compared with that of atenolol (100 mg o.i.d.) following a treatment period of 6 days. The study was performed in 24 patients with documented coronary artery disease and stable angina pectoris according to a double-blind randomized study, designed using conventional symptom-limited exercise testing. Exercise testing 3 h after the first dose showed a more marked ST-segment reduction by atenolol than by nebivolol (59% vs. 18%). ST-segment depression measured 24 h after administration of the penultimate dose was statistically significantly reduced by nebivolol (from 0.19 +/- 0.07 to 0.13 +/- 0.07 mV; P = 0.0059) but not by atenolol (from 0.17 +/- 0.06 to 0.14 +/- 0.10 mV; P = 0.0703). Approximately 3 h after the last dose, the reduction was comparable (45% and 38% by nebivolol and atenolol, respectively). Exercise duration, exercise time necessary to produce ST-segment depression by 0.1 mV and exercise time to the onset of angina were also prolonged following administration of both drugs. Thus, at steady-state single daily doses of 100 mg atenolol and 5 mg nebivolol were about equieffective when measured at time of maximal effect (i.e. 3 h after drug administration). However, duration of action with respect to the ST-segment depression seems to be slightly longer for nebivolol.
Ruf
G
G
Abteilung für Klinische Pharmakologie, Benedikt Kreutz Rehabilitationszentrum, Bad Krozingen, Germany.
Trenk
D
D
Jähnchen
E
E
Roskamm
H
H
D000319:Adrenergic beta-Antagonists / Q000009:adverse effects / Q000097:blood / Q000627:therapeutic use*; D000328:Adult; D000368:Aged; D000787:Angina Pectoris / Q000503:physiopathology / Q000517:prevention & control; D001262:Atenolol / Q000009:adverse effects / Q000097:blood / Q000627:therapeutic use*; D001578:Benzopyrans / Q000009:adverse effects / Q000097:blood / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects; D003327:Coronary Disease / Q000150:complications* / Q000503:physiopathology; D004311:Double-Blind Method; D004562:Electrocardiography / Q000187:drug effects; D004983:Ethanolamines / Q000009:adverse effects / Q000097:blood / Q000627:therapeutic use*; D005080:Exercise Test; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000517:prevention & control*; D000068577:Nebivolol; D014665:Vasodilator Agents / Q000009:adverse effects / Q000097:blood / Q000627:therapeutic use*
D000319:Adrenergic beta-Antagonists; D001578:Benzopyrans; D004983:Ethanolamines; D014665:Vasodilator Agents; D000068577:Nebivolol; D001262:Atenolol