Nebivolol in the Management of Essential Hypertension: A Review

McNeely, W.; Goa, K.L.
April 1999
Drugs;Apr1999, Vol. 57 Issue 4, p633
Academic Journal
Nebivolol is a lipophilic β-blocker. It is devoid of intrinsic sympathomimetic or membrane stabilising activity but appears to have nitric oxide-mediated vasodilatory effects. Nebivolol is administered as a racemic mixture of equal proportions of d- and l-enantiomers. The drug does not significantly influence glucose or plasma lipid metabolism and appears to have a protective effect on left ventricular function. At the recommended dosage (5mg once daily) nebivolol reduces resting diastolic blood pressure as effectively as standard therapeutic dosages of atenolol, metoprolol, lisinopril and nifedipine, as shown in comparative trials. Nebivolol reduced blood pressure significantly more than enalapril 10mg daily in the short but not the long term, although the enalapril dose may not have been optimal. Nebivolol has an additive effect in combination with hydrochlorothiazide. Standing blood pressure and/or mean 24-hour ambulatory blood pressure is significantly and similarly reduced with nebivolol, atenolol or nifedipine. Nebivolol tended to prevent increases in early morning blood pressure better than nifedipine. Overall response rates to nebivolol therapy (a decrease in sitting/supine diastolic blood pressure to ≤90mm Hg or a 10% or ≥10mm Hg fall in diastolic blood pressure) ranged from 58 to 81% after 4 to 52 weeks' treatment. In comparative studies, response rates were greater in nebivolol than in enalapril or metoprolol recipients, but not significantly different from those in atenolol or nifedipine recipients. Nebivolol 5mg once daily is well tolerated in patients with hypertension. Adverse events are infrequent, transient and mild to moderate. Those reported most often include headache, fatigue, paraesthesias and dizziness. Several studies reported no signs of orthostatic hypotension with nebivolol. Comparative trials revealed no significant differences between the frequency and severity of adverse events in patients receiving nebivolol, atenolol, enalapril or placebo; however, the overall incidence of adverse events was greater with nifedipine or metoprolol. Some atenolol or enalapril, but not nebivolol, recipients reported impotence or decreased libido during therapy. Conclusion: Current evidence indicates that nebivolol 5mg once daily is a well tolerated β-blocker, which is as effective as once daily atenolol and other classes of antihypertensive agents. It may therefore be recommended as a useful alternative first-line treatment option for the management of patients with mild to moderate uncomplicated essential hypertension.


Related Articles

  • Positive effect of an oral magnesium therapy in borderline hypertension. Kisters, K.; Funke, C.; Cziborra, M.; Tokmak, F.; Mücke, R.; Micke, O.; Büntzel, J.; Gremmler, B.; Hausberg, M. // Trace Elements & Electrolytes;2012 3rd Quarter, Vol. 29 Issue 3, p221 

    A conference paper about the effect of oral magnesium therapy in the treatment of primary hypertension is presented.

  • Unprocessed bran and its effect on urinary calcium excretion in idiopathic hypercalciuria. Shah, P.J.R.; Green, N.A.; Williams, G. // British Medical Journal;8/9/1980, Vol. 281 Issue 6237, p426 

    Investigates the effects of unprocessed bran on urinary calcium excretion in patients with idiopathic hypercalciuria. Effectiveness of unprocessed brans; Factors responsible for the reduction of stones in urinary calcium excretion; Occurrence of idiopathic hypercalciuria in patients with...

  • Intracranial idiopathic hypertension: 1-year follow-up study. D'Amico, D.; Curone, M.; Erbetta, A.; Farago', G.; Bianchi-Marzoli, S.; Ciasca, P.; Bussone, G.; Chiapparini, L. // Neurological Sciences;May2014 Supplement, Vol. 35, p177 

    Standard guidelines for ongoing management, as well as definitive data about the long-term course of idiopathic intracranial hypertension (IIH) are not available. The aim of this study was to compare several clinical and instrumental variables as assessed at the time of diagnosis and then after...

  • DIASTOLIC ARTERIAL HYPERTENSION. Martorell, Fernando // Angiology;Apr1951, Vol. 2 Issue 2, p108 

    Comments on the challenges facing the diagnosis and treatment of diastolic arterial hypertension. Lack of effective treatment due to the ignorance on the pathogenesis of such disorder; Use of adrenaline substance to diagnose the condition; Ways to perfect the methods of handling essential...

  • Serum Ionized Calcium -- A Predictor of Therapeutic Response To Slow Calcium Channel Blockade in Essential Hypertension. Midtbo, Kjell; Hals, Ottar // Angiology;Nov1987, Vol. 38 Issue 11, p841 

    In 20 patients with mild to moderate essential hypertension, serum ionized calcium was determined before and after four weeks of treatment with 240 mg verapamil sustained release bid. Pretreatment systolic blood pressure was inversely correlated to serum ionized calcium (r=-0.44, p=0.05). Mean...

  • Eplerenone: A Review of its Use in Essential Hypertension. Croom, Katherine F.; Perry, Caroline M. // American Journal of Cardiovascular Drugs;2005, Vol. 5 Issue 1, p51 

    Eplerenone is a selective aldosterone blocker (SAB) approved for the treatment of essential hypertension. Oral eplerenone reduced BP effectively in patients with essential hypertension, both as monotherapy and in combination with other agents. The drug is generally well tolerated; the risk of...

  • Review: atenolol may be ineffective for reducing cardiovascular morbidity or all cause mortality in hypertension. Kennedy Cruickshank, J. // Evidence Based Medicine;Jun2005, Vol. 10 Issue 3, p74 

    The article presents information on a recent study published in the 2004 issue of the journal Lancet. The study found that in patients with essential hypertension, atenolol is not better than placebo or no treatment for reducing cardiovascular morbidity or all cause mortality. However, compared...

  • Valsartan.  // Reactions Weekly;2/23/2013, Issue 1440, p33 

    The article presents a case study of a 85-year-old woman with a history of essential hypertension, presented with an acute onset of tongue swelling, developed angioedema during treatment with valsartan.

  • Assessment of the use of angiotensin receptor blockers in major European markets among paediatric population for treating essential hypertension. Balkrishnan, R.; Phatak, H.; Gleim, G.; Karve, S. // Journal of Human Hypertension;Jun2009, Vol. 23 Issue 6, p420 

    This study was conducted to assess the use of angiotensin receptor blockers (ARBs) in European paediatric patients experiencing essential hypertension. This was a retrospective analysis of the IMS MIDAS Prescribing Insight Medical Database. Five major important European markets, including...


Read the Article

Courtesy of

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics