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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 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 P P P 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. |
