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J Hum Hypertens. 2017 Dec;32(1):20-25. doi: 10.1038/s41371-017-0019-9. Epub 2017 Nov 28.

Effect of nebivolol or atenolol vs. placebo on cardiovascular health in subjects with borderline blood pressure: the EVIDENCE study.

Author information

1
Cardiovascular Division, University of Minnesota Medical School, 420 Delaware Street Southeast, Minneapolis, MN, 55455, USA.
2
Cardiovascular Division, University of Minnesota Medical School, 420 Delaware Street Southeast, Minneapolis, MN, 55455, USA. cohnx001@umn.edu.

Abstract

Pharmacotherapy to protect the arteries may be appropriate for individuals with high-normal blood pressure who are at risk for future cardiovascular disease (CVD). Nebivolol (NEB) in contrast to atenolol (ATE) may have a beneficial effect on endothelial function and may be more effective than ATE in preventing CVD. Sixty subjects with preHTN or borderline BP and abnormal small artery elasticity (SAE) underwent evaluation with 10 tests, including large and small artery elasticity, resting and treadmill exercise BP, carotid intimal-media thickness, retinal vascular photography, micro-albuminuria, electrocardiography, echocardiography, and plasma B-type natriuretic peptide level. Each test scored as normal (0), borderline (1), or abnormal (2), and the total disease score (DS) was calculated by adding the test scores. Subjects were randomized double-blind to placebo (PLAC, n = 22), NEB 5/10 mg/day (n = 20), or ATE 25/50 mg/day (n = 18) once daily for 9 months. After 9 months, in the group receiving NEB the mean (standard deviation) DS decreased from baseline 4.3 (2.6) to 2.8 (2.4) (P < 0.007), with ATE from 5.4 (2.5) to 3.5 (1.9) (P = 0.0006), and with PLAC from 5.2 (3.0) to 4.5 (2.6) (P = 0.18). SAE increased in the NEB group from 6.0 (2.2) to 8.4 (3.4) ml/mmHg × 100 (P = 0.0001), whereas there was no significant change in the ATE and PLAC groups. Thus, nebivolol improves small artery function more than atenolol in asymptomatic subjects with preHTN or borderline BP, despite their similar BP-lowering effect.

TRIAL REGISTRATION:

ClinicalTrials.gov NCT01522950.

PMID:
29184167
DOI:
10.1038/s41371-017-0019-9
[Indexed for MEDLINE]

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