A dose-response trial of nebivolol in essential hypertension

Nueten, Luc Van; Dupont, Alain; Vertommen, C.; Goyvaerts, Harry; Robertson, J. I. S.

doi:10.1038/sj.jhh.1000392

Cited by 43 publications

(27 citation statements)

References 3 publications

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“…6,14,15 Nebivolol also provided significant dose-dependent BP reductions in clinical trials in hypertensive patients and was safe and well tolerated. 6,14,[16][17][18][19] The objective of this study was to assess the BPlowering efficacy and safety of once-daily nebivolol added to ongoing antihypertensive therapy in patients with uncontrolled stage I-II hypertension.…”

Section: Introductionmentioning

confidence: 99%

Adding nebivolol to ongoing antihypertensive therapy improves blood pressure and response rates in patients with uncontrolled stage I–II hypertension

2009

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This study assessed blood pressure (BP) reductions and response rates following addition of nebivolol to ongoing antihypertensive therapy in patients with uncontrolled stage I-II hypertension despite antihypertensive treatment. Patients with an average sitting diastolic BP (SiDBP) X90 and p109 mm Hg while taking an antihypertensive regimen were included in this double-blind, placebo-controlled, parallel-group study. The primary efficacy end point was reduction from baseline to week 12 in mean trough SiDBP. In total, 669 patients were randomized to once-daily nebivolol 5, 10 or 20 mg or placebo. Addition of nebivolol 5, 10 and 20 mg significantly reduced BP; placebo-subtracted least squares mean reductions in trough SiDBP were À3.3, À3.5 and À4.6 mm Hg, respectively (Po0.001) and À5.7, À3.7 and À6.2 mm Hg in trough sitting systolic BP (SiSBP), respectively (Pp0.015). Adding nebivolol 5-20 mg resulted in significantly more responders (SiDBP o90 or X10 mm Hg reduction; range: 53.0-65.1 vs 41.3% with placebo; Pp0.028) and significantly better control rates (SiSBP/ SiDBP o140/90 mm Hg; range: 41.3-52.7 vs 29.3% with placebo; Pp0.029). Nebivolol was well tolerated; the incidence of adverse events with nebivolol was similar to that with placebo (40.2 vs 38.9%, respectively; P ¼ 0.763). Addition of once-daily nebivolol to ongoing antihypertensive therapy provided significant additional BP reductions and better response rates in patients with uncontrolled hypertension and was well tolerated.

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Section: Introductionmentioning

confidence: 99%

Adding nebivolol to ongoing antihypertensive therapy improves blood pressure and response rates in patients with uncontrolled stage I–II hypertension

2009

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“…It acts partly through the l-arginine/nitric oxide pathway, has vasodilating effects, and iod, the increase in fatigue was found to be more prominent with atenolol than with nebivolol or plaimproves large arterial compliance. [1][2][3][4][5][6][7][8][9][10]12 Nebivolol has been shown to enhance left ventricular function cebo (Table 3).…”

Section: Methodsmentioning

confidence: 99%

“…A previous dosewith vasodilating properties and a prolonged action; response trial of nebivolol had shown that 5 mg it acts in part via the l-arginine/nitric oxide pathonce daily in hypertensive patients controlled blood way. At similar anti-hypertensive doses, nebivolol pressure (BP) over 24 h; no additional effect was has been found to exert less beta-1 blockade than do seen with 10 mg. 10 Likewise, atenolol 50 mg once standard beta-blockers, as judged by the extent of daily had earlier been found to be as effective as reduction of exercise-induced tachycardia. [1][2][3][4][5][6][7][8][9] This 100 mg. 11 Thus the doses of active drugs used were paper reports a double-blind randomised trial of nebivolol 5 mg and atenolol 50 mg.…”

Section: Introductionmentioning

confidence: 99%

Nebivolol vs atenolol and placebo in essential hypertension: a double-blind randomised trial

Nueten

Taylor²,

Robertson

1998

J Hum Hypertens

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A double-blind, randomised, parallel-group trial was cant falls in heart rate. Both active drugs were well tolerconducted in patients with essential hypertension in ated, nebivolol marginally more so. Nebivolol, a longBritish general practices, of nebivolol 5 mg, atenolol acting, cardioselective, vasodilating beta-blocker which 50 mg, and placebo each given once daily. Both active acts partly via the l-arginine/nitric oxide mechanism, drugs, in comparison with placebo, caused highly sigappears potentially valuable for the treatment of hypernificant and similar reductions in systolic and diastolic tension. pressures without orthostatic effect, and small signifiKeywords: nitric oxide; quality of life; side effects daily were begun. After 4 weeks of this single-blind

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“…A large observational study of nebivolol monotherapy in patients with hypertension (N = 6376) found that the rate of response in patients older than 65 years and older than 75 years (92.9% in both) was similar to that in patients younger than 65 years (92.8%) [53]. In addition, a large, randomized, placebo-controlled, dose-ranging study (N = 509) found that nebivolol had similar efficacy in hypertensive black patients as in white patients, with average BP reductions at trough of -9.7/8.5 mm Hg and -9.0/9.4 mm Hg, respectively [54].…”

Section: Blood Pressure Reductionmentioning

confidence: 74%

The vasodilatory beta-blockers

Pedersen¹,

Cockcroft

2007

Current Science Inc

122

102

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Although well established in treating hypertension and cardiovascular (CV) disease, clinical trial data suggest that beta-blockers (eg, atenolol) may be less effective than other antihypertensive classes in reducing stroke and CV mortality despite similar blood pressure (BP) reductions. One possible explanation is that atenolol is less effective in reducing central aortic pressure. Newer vasodilating beta-blockers may prove more effective in reducing central pressure and cardiovascular events. Carvedilol and labetalol appear to cause vasodilation through alpha(1)-receptor blockade; nebivolol induces endothelium-dependent vasodilation by stimulating nitric oxide bioactivity. Their favorable hemodynamic profile includes reduction of peripheral vascular resistance (PVR) while maintaining or improving cardiac output (CO), stroke volume, and left ventricular function, whereas nonvasodilating beta-blockers tend to raise PVR and reduce CO and left ventricular function. Compared with conventional beta-blockers, vasodilating beta-blockers have beneficial hemodynamic effects including decreased pressure wave reflection from the periphery, leading to decreases in central aortic blood pressure. Larger trials are needed to determine whether reduced central pressure will translate into improved CV outcomes compared with nonvasodilating beta-blockers.

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A dose-response trial of nebivolol in essential hypertension

Cited by 43 publications

References 3 publications

Adding nebivolol to ongoing antihypertensive therapy improves blood pressure and response rates in patients with uncontrolled stage I–II hypertension

Adding nebivolol to ongoing antihypertensive therapy improves blood pressure and response rates in patients with uncontrolled stage I–II hypertension

Nebivolol vs atenolol and placebo in essential hypertension: a double-blind randomised trial

The vasodilatory beta-blockers

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