Beta-blockers in the treatment of arterial hypertension

Koriagina N. A., Avdeev A. V., Melekhova O. B., Shadrin A. A., Prokhorov K. V., Naumov S. A.

Objective: to compare the effects of two beta-blockers of carvedilol and nebivolol in patients with arterial hypertension. Materials and methods: 60 patients with hypertension and without previous antihypertensive therapy were included in the study. 10 days after the onset of the placebo, they were randomized. In groups of 20 people for a month were: placebo, carvedilol 25 mg and nebivolol 5 mg, once a day in the morning. A 24-hour outpatient measurement of blood pressure was performed. To assess the endothelial function, the level of endothelin-1 activity was determined by the method of enzyme immunoassay. Results: the group consisted of 26 women and 34 men, whose mean age was 45.9 ± 11.8 years. The mean heart rate was significantly reduced after treatment with carvedilol (68.2 ± 5.2 bpm) and nebivolol (65.1 ± 4.2 bpm) compared with placebo (78.8 ± 5.2 beats / min) (p <0.05). Both carvedilol (133.9 ± 9.2 / 86.7 ± 8.6 mm Hg) and nebivolol (134.4 ± 8.8 / 85.4 ± 7.4 mm Hg) significantly decreased mean systolic and diastolic arterial pressure in comparison with placebo (143.9 ± 8.9 / 94.4 ± 9.2 mm Hg), respectively (p <0.05). However, there was no significant difference in the reduction in pressure between nebivolol and carvedilol therapy (p> 0.05). In the appointment of nebivolol, there is a significant reduction in endothelin-1 with a reliable direct relationship between the degree of decrease in the concentration of the vasoconstrictor and the degree of systolic pressure reduction (r = 0.404, p = 0.041). Conclusion: carvedilol and nebivolol lowered blood pressure compared with placebo, they showed similar efficacy. With the appointment of nebivalol, a marked decrease in the endocellular vasoconstrictor-1 was recorded.

Keywords:arterial hypertension, nebivolol, carvedilol, beta-blocker