Comparative Effects of a New Cardioselective Beta‐Blocker Nebivolol and Nifedipine Sustained‐Release on 24‐Hour Ambulatory Blood Pressure and Plasma Lipoproteins

Abstract

This double‐blind, parallel‐group study compared the effects of Nebivolol, a novel cardioselective β‐blocker, with those of nifedipine sustained‐release on 24‐hour ambulatory blood pressure and plasma lipoprotein levels. After a washout period of 8 weeks, 51 patients with mild to moderate essential hypertension were randomized to double‐blind treatment with either nebivolol 5 mg once a day (n = 26) or nifedipine sustained‐release 20 mg bid (n = 25) over a period of 12 weeks. Both treatments produced similar and significant (P = .0001) reduction in office blood pressure as well as in 24‐hour, work, awake, and sleep ambulatory blood pressure. The clinical response (diastolic blood pressure < 90 mmHg or decreased by ≥10 mmHg) rate was 69% for nebivolol and 59% for nifedipine, respectively. Moreover, the nebivolol and nifedipine treatment‐induced decreases in mean 24‐hour ambulatory blood pressure were similar to the decreases in clinic blood pressure. Furthermore, the percentages of “blood pressure loads” (awake > 140/90 mmHg and asleep > 120/80 mmHg) were lowered significantly (P = .0001), from 60% to 29% with nebivolol and from 60% to 39% with nifedipine. Mean ambulatory heart rate was reduced (P = .0001) from 79 ± 7 to 68 ± 7 beats/minute during nebivolol therapy and from 80 ± 9 to 79 ± 7 (not significant) with nifedipine. Total plasma cholesterol and low‐density lipoprotein levels decreased significantly (P < .05) by 5 and 8%, respectively, after nebivolol treatment, and each decreased by 3% after nifedipine treatment. The results showed that both drugs controlled blood pressure during the 24‐hour period and seemed devoid of untoward effects on lipid profile.