Effects of nebivolol versus bisoprolol on endothelial function in hypertensive patients.
OBJECTIVE
To determine the effects of two beta-blockers, nebivolol and bisoprolol, on endothelial function in newly diagnosed hypertensive patients.


METHODS
Twenty-five hypertensive patients with a mean (+/- SD) age of 45.3+/-11.5 years were randomly assigned to receive either nebivolol or bisoprolol for eight weeks in an open-label, crossover design. Flow-mediated endothelial-dependent vasodilation (FMD) was measured at baseline and after each eight-week treatment period. At the end of each treatment period, 24 h ambulatory blood pressure (BP) monitoring was performed.


RESULTS
The effect of the two beta-blockers on BP was similar. The mean FMD before initiation of treatment was 4.14+/-3.55%. After treatment with nebivolol, FMD increased to 8.99+/-4.21%, with a statistically significant difference from baseline (P<0.001). The effect of bisoprolol treatment on FMD was not as dramatic (3.72+/-6.84%), with no statistically significant difference from baseline. Comparing FMD after each therapeutic regimen, nebivolol treatment resulted in a marked increase in the reactivity of the brachial artery (ie, improvement of endothelial function) compared with bisoprolol treatment (P<0.001).


CONCLUSIONS
Nebivolol treatment of untreated hypertensive patients led to a significant improvement in endothelial function compared with bisoprolol treatment, despite the similar effect on BP with either therapeutic agent.
Simova
Iana Ivaylova
II
Department of Noninvasive Functional and Imaging Diagnostics, National Cardiology Hospital, Sofia;
Todorova-Konstantinova
Rumiana Radoslavova
RR
Denchev
Stefan Veselinov
SV