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• W2024851185 abstract "Background: The antihypertensive activity of beta-blockers generally increases during the first 6 to 8 weeks of treatment; however, no study has systematically assessed whether blood pressure continues to decrease with prolonged treatment. Nebivolol is a third-generation beta-blocker that combines beta-blocking activity with nitric oxide—mediated vasodilatory properties. It is not known whether this combination of properties provides better long-term control of blood pressure than other monotherapies. Objectives: The purpose of this study was to determine whether the antihypertensive activity of nebivolol continues to increase over a 6-month period and to assess the efficacy and safety of nebivolol monotherapy over 6 months in previously untreated and treated hypertensive patients. Methods: Patients who had not been treated previously for hypertension took nebivolol 5 mg once daily. Those who had been treated previously replaced their monotherapy with nebivolol 5 mg once daily starting the day after the first evaluation. Patients were evaluated at baseline and 12, 212, and 6 months after nebivolol treatment and were defined as responders if their diastolic blood pressure (DBP) was <90 mm Hg or the decrease in DBP versus baseline was >10 mm Hg. Patients answered a self-administered questionnaire about general feelings of well-being, compliance with treatment, and side effects. Results: A total of 3741 patients were enrolled; 1656 patients had been treated previously for hypertension. A total of 461 (12.3%) patients did not complete the study. In previously untreated patients, nebivolol reduced blood pressure by 19/11 mm Hg after 12 month and by 24/14 mm Hg after 6 months. In previously treated patients, mean blood pressure reductions were 9/7 mm Hg after 12 month and 14/8 mm Hg after 6 months (P < 0.001 for all differences from baseline). After 212 months of treatment, blood pressures were not significantly different from those obtained at 12 month; however, blood pressures at 6 months were significantly different from those measured at 12 month (P < 0.05). After 12 month, 61% of previously untreated patients and 52% of treated patients were responders; after 6 months 86% and 74%, respectively, were responders (P < 0.01 12 vs 6 months for both treated and untreated patients). Serious adverse effects considered unrelated to the study drug were dementia, malignancy, myocardial infarction, and septic shock. Minor adverse effects were mild and included transient headache (1.9%), dizziness (1.3%), and fatigue (1.3%) and were not considered reasons for withdrawal; 97 patients (2.6%) preferred not to continue the trial because of side effects. After 6 months, 73% of patients (95% CI, 60%–82%) reported that their general feeling of well-being had improved during the past 6 months, whereas only 5% reported that it had deteriorated. Among previously treated patients, 67% (95% CI, 54%–76%) reported at 6 months that they tolerated nebivolol better than their previous treatment, whereas only 2.4% reported that the previous treatment was better tolerated (P < 0.001 for both comparisons). Conclusions: In this study nebivolol was effective and well tolerated in the long term, and its antihypertensive activity continued to increase during the first 6 months of treatment." @default.
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• W2024851185 date "2001-06-01" @default.
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• W2024851185 title "Long-term efficacy of Nebivolol monotherapy in patients with hypertension" @default.
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• W2024851185 doi "https://doi.org/10.1016/s0011-393x(01)80056-4" @default.
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