To study the comparative effects of nebivolol and metoprolol on lipid profile in patients of essential hypertension

Abstract

INTRODUCTIONEssential or primary hypertension is the most prevalent type, affecting between 90% and 95% of patients diagnosed with hypertension.1 It has been reported to be the fourth contributor to premature death in developed countries and the seventh in developing countries.2 Recent reports indicate that nearly 1 billion adults (more than a quarter of the world's population) had hypertension in 2000, and this is predicted to increase to 1.56 billion by 2025.3 However, prevalence of hypertension in India, for the last three decades has increased by about 30 times among urban residents and by about 10 times among rural residents. 4 Hypertension and certain alteration in serum lipoproteins are complementary coronary risk factors. Several studies have indicated that high concentrations of low-density lipoprotein (LDL) cholesterol and triglyceride (TG) are strong risk factors for the development of cardiovascular disease (CVD). 5,6 It has been reported that the effect of antihypertensive agents on lipid metabolism exhibits a wide range. Some have adverse effect on the lipid profile whereas others have a neutral or favorable effect on it.7 Beta-adrenergic receptor antagonists (beta-blockers) are widely used for the management of CVDs and have been proved efficacious in the treatment of hypertension, coronary heart disease, including angina pectoris, myocardial infarction, and heart failure. Sixty patients of either sex in the age group of 30-65 years with blood pressure (BP) of ≥140/90 mmHg with deranged lipid parameters according to National Cholesterol Education Program were randomized into two groups. Group I received metoprolol (50 mg) and Group II received nebivolol (5 mg), both given once daily for 12 weeks. BP and lipid parameters were evaluated at baseline as well as at the end of 12 weeks. Results: There was significant reduction in BP values (p<0.0001) as compared to baseline in both the groups, however no significant difference was observed between two drugs revealing that their efficacy in reducing systolic BP/diastolic BP is comparable. Furthermore, both the drugs had a favorable effect on lipid profile, but more significant results on lipid profile were observed in the nebivolol group as compared to metoprolol group (p<0.0001). Conclusions: In our comparison study, it is seen that the favorable effect of nebivolol on serum lipids and its good tolerability profile make it a good choice for control of hypertension as well as preventing the long-term cardiovascular morbidities and mortalities.