title: Effects of add-on nebivolol on blood pressure and glucose parameters in hypertensive patients with prediabetes.
abstract: In this multicenter trial, the effects of nebivolol added to an angiotensin-converting enzyme (ACE) inhibitor or angiotensin II receptor blocker (ARB) were assessed in patients with hypertension (diastolic blood pressure [DBP] 80-110 mm Hg) and prediabetes (fasting blood glucose 100-125 mg/dL and/or 2-hour oral glucose tolerance test [OGTT] 140-199 mg/dL). After a 4-week run-in period (in which lisinopril [10 mg/d] or losartan [50 mg/d] treatment was initiated), patients with DBP 90-110 mm Hg were randomized (2:2:1) to 12-week, double-blind treatment with nebivolol (n=223; 5-40 mg/d), hydrochlorothiazide (HCTZ; n=212; 12.5-25 mg/d), or placebo (n=102), titrated to achievement of 130/80 mm Hg. The primary outcome measure was DBP (last observation carried forward, intent to treat population); secondary measures included systolic blood pressure (SBP) and glucose levels. At baseline, overall mean values for body mass index, triglycerides, and high-density lipoprotein cholesterol were 32.3 kg/m(2) , 1.7 mmol/L, and 1.3 mmol/L, respectively. At week 12, nebivolol and placebo groups demonstrated a decrease of -9.4 and -5.0 mm Hg, respectively (P<.001) for DBP and -10.4 and -7.8 mm Hg for SBP (P=.147). The mean changes in area under the curve OGTT were 0.0 mg/dL (nebivolol), 6.9 mg/dL (HCTZ; P=.024 vs nebivolol), and -1.0 mg/dL (placebo). Adverse event-related discontinuation rates were 10.3%, 6.6%, and 2.0%, respectively. Nebivolol, added to an ACE inhibitor or ARB, provides additional blood pressure reduction with little or no effect on glucose metabolism in hypertensive patients with prediabetes.
authors.affiliation: Department of Medicine, UCSF School of Medicine, University of California-San Francisco, CA, USA. deed1@sbcglobal.net
authors.forename: Prakash
authors.initials: P
authors.lastname: Deedwania
authors.forename: John
authors.initials: J
authors.lastname: Shea
authors.forename: Wei
authors.initials: W
authors.lastname: Chen
authors.forename: Lillian
authors.initials: L
authors.lastname: Brener
mesh_terms: D000328:Adult; D000368:Aged; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000008:administration & dosage / Q000009:adverse effects; D000959:Antihypertensive Agents / Q000008:administration & dosage / Q000009:adverse effects; D019540:Area Under Curve; D001578:Benzopyrans / Q000008:administration & dosage / Q000009:adverse effects; D001794:Blood Pressure / Q000187:drug effects*; D004311:Double-Blind Method; D016903:Drug Monitoring; D004359:Drug Therapy, Combination; D004983:Ethanolamines / Q000008:administration & dosage / Q000009:adverse effects; D005260:Female; D005947:Glucose / Q000378:metabolism*; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D000068577:Nebivolol; D011236:Prediabetic State / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D016896:Treatment Outcome
chemical_list: D000806:Angiotensin-Converting Enzyme Inhibitors; D000959:Antihypertensive Agents; D001578:Benzopyrans; D004983:Ethanolamines; D000068577:Nebivolol; D005947:Glucose
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