Effect of nebivolol monotherapy or combination therapy on blood pressure levels in patients with hypertension: an updated systematic review and multilevel meta-analysis of 91 randomized controlled trials.

Autor: Manolis A; 2nd Department of Cardiology, Metropolitan Hospital, Piraeus, Greece., Karakasis P; Second Department of Cardiology, Aristotle University of Thessaloniki, General Hospital Hippokration, Thessaloniki, Greece., Patoulias D; Second Propedeutic Department of Internal Medicine, Aristotle University, Thessaloniki, Greece., Doumas M; Second Propedeutic Department of Internal Medicine, Aristotle University, Thessaloniki, Greece., Kallistratos M; 2nd Department of Cardiology, Metropolitan Hospital, Piraeus, Greece. kallistrat1972@gmail.com., Thomopoulos C; Department of Cardiology, LaikoHospital, Athens, Greece., Koutsaki M; Cardiology Department, Asklepeion General Hospital, Voula, Greece., Grassi G; Clinica Medica, University of Milano-Bicocca, Milan, Italy., Mancia G; ESH Foundation/ESH Educational Board, University Milano-Bicocca, Milan, Italy.
Jazyk: angličtina
Zdroj: High blood pressure & cardiovascular prevention : the official journal of the Italian Society of Hypertension [High Blood Press Cardiovasc Prev] 2024 Oct 29. Date of Electronic Publication: 2024 Oct 29.
DOI: 10.1007/s40292-024-00687-5
Abstrakt: Aims: To systematically appraise and summarize the available evidence from published randomized controlled trials considering the effect of nebivolol on blood pressure in patients with hypertension.
Methods: Literature search was performed through Medline (via PubMed), Cochrane Library and Scopus until December 15, 2023. Double-independent study selection, data extraction and quality assessment were performed. Evidence was pooled with three-level mixed-effects meta-analysis.
Results: In total, 7,737 participants with hypertension, who were treated with nebivolol, were analyzed across 91 RCTs. Nebivolol was associated with significantly greater reduction in office systolic and diastolic BP compared to placebo (MD = - 6.01 mmHg; 95% CI = [- 7.46, - 4.55] and MD = - 5.01 mmHg; 95% CI = [- 5.91, - 4.11], respectively). Moreover, resulted a similar reduction in systolic BP (MD = - 0.22 mmHg; 95% CI = [- 0.91, 0.46]) and a significantly greater reduction in diastolic BP compared to the active comparator (MD = - 0.71 mmHg; 95% CI = [- 1.27, - 0.16]). When considering the effect of nebivolol on 24-hour ambulatory BP, notable reductions were observed compared to placebo. In contrast, compared to the active comparators, there was no significant difference in systolic BP reduction, but a significant reduction in diastolic BP favoring nebivolol. Based on moderator analyses, the impact of nebivolol on the pooled estimates remained independent of the dose of nebivolol, age, male sex, trial duration, body mass index (BMI), baseline diabetes, heart failure, and baseline systolic and diastolic BP.
Conclusion: Nebivolol, compared to placebo, showed a significant BP reduction and was non-inferior to other active comparators in terms of BP reduction.
(© 2024. The Author(s).)
Databáze: MEDLINE
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