Comparative effects of nebivolol and metoprolol on red cell distribution width and neutrophil/lymphocyte ratio in patients with newly diagnosed essential hypertension.
High level of circulating red cell distribution width (RDW) and neutrophil/lymphocyte (N/L) ratio may reflect ongoing vascular inflammation and play an important role in pathophysiology of hypertension. We evaluate the effects of nebivolol and metoprolol on the RDW and N/L in new essential hypertensive patients. After baseline assessment, 72 patients were randomly allocated to 5 mg/d of nebivolol (n = 37, 20 men) or 100 mg/d of metoprolol (n = 35, 18 men) and treated for 6 months. Blood pressure (BP), heart rate (HR), RDW, and N/L were measured before and after treatment. BP significantly decreased with both drugs (P < 0.001). Analog reduction was observed for resting HRs (P < 0.001), but metoprolol caused greater HR fall as compared with nebivolol (P < 0.001). After 6 months of treatment, nebivolol significantly lowered not only RDW but also the total white blood cell and N/L (P < 0.001, P = 0.023, P = 0.017, respectively). No changes were observed in metoprolol group. Percent decrease in RDW was found to be significantly higher in nebivolol than in the metoprolol group (P = 0.001) and remained also after correction for confounders (P = 0.012). Nebivolol improved RDW and N/L to a greater extent than metoprolol in patients with hypertension. These favorable effects may participate, together with the BP reduction, at the favorable properties of the drug in hypertension.
*Clinica Medica, Università Milano-Bicocca, Milan, Italy; †Department of Cardiology, Gulhane Military Medical Academy, Ankara, Turkey; ‡Department of Cardiology, Beytepe Military Hospital, Beytepe, Ankara, Turkey; §Department of Medical Biochemistry, Gulhane Military Medical Academy, Ankara, Tureky; ¶GATA Haydarpasa Eğitim Hastanesi Kardiyoloji Servisi, Istanbul, Turkey; ‖Department of Epidemiology, Gulhane Military Medical Academy, Ankara, Turkey; and **Istituto di Ricerche a Carattere Scientifico IRCCS Multimedica, Milan, Italy.
Francesco
F
Fici
Turgay
T
Celik
Sevket
S
Balta
Atila
A
Iyisoy
Murat
M
Unlu
Sait
S
Demitkol
Halil
H
Yaman
Gianmaria
G
Brambilla
Ejder
E
Kardesoglu
Selim
S
Kilic
Mehemet
M
Yokusoglu
Guido
G
Grassi
D000328:Adult; D000959:Antihypertensive Agents / Q000494:pharmacology* / Q000627:therapeutic use; D001578:Benzopyrans / Q000494:pharmacology* / Q000627:therapeutic use; D001794:Blood Pressure / Q000187:drug effects; D004311:Double-Blind Method; D004909:Erythrocyte Indices; D000075222:Essential Hypertension; D004983:Ethanolamines / Q000494:pharmacology* / Q000627:therapeutic use; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D007958:Leukocyte Count; D008214:Lymphocytes / Q000187:drug effects / Q000378:metabolism; D008297:Male; D008790:Metoprolol / Q000494:pharmacology* / Q000627:therapeutic use; D008875:Middle Aged; D000068577:Nebivolol; D009504:Neutrophils / Q000187:drug effects / Q000378:metabolism; D011446:Prospective Studies; D016896:Treatment Outcome
D000959:Antihypertensive Agents; D001578:Benzopyrans; D004983:Ethanolamines; D000068577:Nebivolol; D008790:Metoprolol