Nebivolol vs amlodipine as first-line treatment of essential arterial hypertension in the elderly.
The antihypertensive efficacy of nebivolol and amlodipine and their tolerability were compared in a multicentre, randomized, active-controlled, double-blind parallel-group trial in elderly patients with mild to moderate essential arterial hypertension. One hundred and eighty-four subjects aged > or = 65 years were screened. After a run-in phase of 4 weeks, only 168 of these were randomized with either nebivolol 2.5-5 mg daily (n = 81) or amlodipine 5-10 mg daily (n = 87) over a period of 12 weeks. The response rate to treatment and the changes of sitting diastolic blood pressure (BP) at week 12 were similar between the two groups. A lower sitting systolic BP (SBP) was detected with amlodipine at week 4 (p < 0.05) and at week 8 (p < 0.05). Standing BP showed no changes between the two groups; only SBP was lower with amlodipine at week 8 (p < 0.05). Heart rate was lower at all treatment visits with nebivolol (p < 0.001). The incidence of adverse events was no different between the two groups; however the incidence of headache and ankle oedema was significantly higher with amlodipine (p < 0.05). In elderly subjects with essential hypertension, the antihypertensive efficacy of nebivolol and amlodipine was similar. Both drugs were well tolerated, although amlodipine was accompanied by higher incidence of drug-related adverse events.
Department of Clinical and Experimental Medicine, Clinica Medica, University of Padova, Italy. alberto.mazza@unipd.it
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Mazza
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Gil-Extremera
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Maldonato
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Toutouzas
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D000368:Aged; D000369:Aged, 80 and over; D017311:Amlodipine / Q000008:administration & dosage* / Q000633:toxicity; D000959:Antihypertensive Agents / Q000008:administration & dosage* / Q000633:toxicity; D001578:Benzopyrans / Q000008:administration & dosage* / Q000633:toxicity; D001794:Blood Pressure / Q000187:drug effects; D004311:Double-Blind Method; D004487:Edema / Q000139:chemically induced; D004983:Ethanolamines / Q000008:administration & dosage* / Q000633:toxicity; D006261:Headache / Q000139:chemically induced; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000188:drug therapy*; D000068577:Nebivolol
D000959:Antihypertensive Agents; D001578:Benzopyrans; D004983:Ethanolamines; D000068577:Nebivolol; D017311:Amlodipine