| Popis: |
Nebivolol, a selective β1-lipophilic blocker, achieves blood pressure control by modulating nitric oxide release in addition to b-blockade. This dual mechanism of action could result in minimum interference with lipid metabolism compared to atenolol, a classic β1-selective blocker. Hypertensive patients commonly exhibit lipid abnormalities and frequently require statins in combination with the anti-hypertensive therapy. We conducted this trial in order to clarify the effect on the metabolic profile of β-blocker therapy with atenolol or nebivolol alone, or in conjunction with pravastatin. Thirty hypertensive hyperlipidemic men and women (total cholesterol >240 mg/dL [6.2 mmol/L], low-density lipoprotein cholesterol >190 mg/dL [4.9 mmol/L], triglycerides .05) and the HOMA index (P = .05). The addition of pravastatin to all patients (n = 30) decreased total cholesterol by 21% (P < .001), low-density lipoprotein cholesterol by 28% (P < .001), apolipoprotein-B by 22% (P < .001), apolipoprotein-E by 15% (P = .014) and lipoprotein(a) levels by 12% (P = .023). Moreover, homocysteine levels and C-reactive protein were reduced by 17% (P = .05) and 43% (P = .05), respectively. We conclude that nebivolol seems to be a more appropriate therapy in hypertensive patients with hyperlipidemia and carbohydrate intolerance. Finally, the addition of pravastatin could further correct the well-established predictors of cardiovascular events. |
