DOI: http://dx.doi.org/10.18203/2319-2003.ijbcp20150043

To study the comparative effects of nebivolol and metoprolol on lipid profile in patients of essential hypertension

Sukhmeen Kaur Johar, Deepak Bhosle, Deepali Jaybhaye, Alimuddin Sheikh

Abstract


Background: Hypertension and certain alteration in serum lipoproteins are complementary coronary risk factors. The effect of antihypertensive agents on lipid metabolism exhibits a wide range. Numerous studies have established that vasodilating beta-blockers are associated with more favorable effects on glucose and lipid profiles than non-vasodilating beta-blockers. The study was conducted to study the comparative effects of nebivolol and metoprolol on lipid profile in patients of essential hypertension.

Methods: A prospective, randomized open label single center study was conducted in the Department of Pharmacology in collaboration with Department of Medicine, MGM’s Medical College and Hospital, Aurangabad in newly diagnosed patients of essential hypertension. Sixty patients of either sex in the age group of 30-65 years with blood pressure (BP) of ≥140/90 mmHg with deranged lipid parameters according to National Cholesterol Education Program were randomized into two groups. Group I received metoprolol (50 mg) and Group II received nebivolol (5 mg), both given once daily for 12 weeks. BP and lipid parameters were evaluated at baseline as well as at the end of 12 weeks.

Results: There was significant reduction in BP values (p<0.0001) as compared to baseline in both the groups, however no significant difference was observed between two drugs revealing that their efficacy in reducing systolic BP/diastolic BP is comparable. Furthermore, both the drugs had a favorable effect on lipid profile, but more significant results on lipid profile were observed in the nebivolol group as compared to metoprolol group (p<0.0001).

Conclusions: In our comparison study, it is seen that the favorable effect of nebivolol on serum lipids and its good tolerability profile make it a good choice for control of hypertension as well as preventing the long-term cardiovascular morbidities and mortalities.


Keywords


Essential hypertension, Beta-blocker, Metoprolol, Nebivolol, Lipid profile

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References


Carretero OA, Oparil S. Essential hypertension. Part I: definition and etiology. Circulation. 2000;101(3):329-35.

Deepa R, Shanthirani CS, Pradeepa R, Mohan V. Is the ‘rule of halves’ in hypertension still valid? - Evidence from the Chennai Urban population study. J Assoc Physicians India. 2003;51:153-7.

Kearney PM, Whelton M, Reynolds K, Muntner P, Whelton PK, He J. Global burden of hypertension: analysis of worldwide data. Lancet. 2005;365(9455):217-23.

Madhkumar S, Gaikwad V, Sudeepa D, Gupta R. An epidemiological study of hypertension and its risk factors in rural population of Bangalore rural district. Al Ameen J Med Sci. 2012;5(3):264-70.

Kannel WB, Carter BL. Initial drug therapy for hypertensive patients with hyperlipidemia. Am Heart J. 1989;118:1012-21.

Halperin RO, Sesso HD, Ma J, Buring JE, Stampfer MJ, Gaziano JM. Dyslipidemia and the risk of incident hypertension in men. Hypertension. 2006;47(1):45-50.

Grimm RH Jr. Antihypertensive therapy: taking lipids into consideration. Am Heart J. 1991;122:910-8.

Weber MA. The role of the new beta-blockers in treating cardiovascular disease. Am J Hypertens. 2005;18:169S-76.

Vyssoulis GP, Karpanou EA, Pitsavos CE, Skoumas JN, Paleologos AA, Toutouzas PK. Differentiation of beta-blocker effects on serum lipids and apolipoproteins in hypertensive patients with normolipidaemic or dyslipidaemic profiles. Eur Heart J. 1992;13(11):1506-13.

Pasotti C, Capra A, Fiorella G, Vibelli C, Chierichetti SM. Effects of pindolol and metoprolol on plasma lipids and lipoproteins. Br J Clin Pharmacol. 1982;13 Suppl 2:435S-39.

Tziomalos K, Athyros VG, Karagiannis A, Mikhailidis DP. Dyslipidemia induced by drugs used for the prevention and treatment of vascular diseases. Open Cardiovasc Med J. 2011;5:85-9.

Liberopoulos EN, Elisaf MS. Clinical use of nebivolol in the treatment of chronic heart failure. Hellenic J Cardiol. 2005;46:208-11.

Van Bortel LM. Efficacy, tolerability and safety of nebivolol in patients with hypertension and diabetes: a post-marketing surveillance study. Eur Rev Med Pharmacol Sci. 2010;14(9):749-58.

Agabiti Rosei E, Rizzoni D. Metabolic profile of nebivolol, a beta-adrenoceptor antagonist with unique characteristics. Drugs. 2007;67(8):1097-107.

Fonseca VA. Effects of beta-blockers on glucose and lipid metabolism. Curr Med Res Opin. 2010;26(3):615-29.

Saha MS, Sana NK, Shaha RK. Serum lipid profile of hypertensive patients in the Northern region of Bangladesh. J Bio Sci. 2006;14:93-8.

Gupta M, Pachori, SB, Pant, M.C. Study of abana and metoprolol on total serum cholesterol, lipoprotein cholesterol and SCBR levels in normal albino rabbits. J Assoc Physicians India. 1991;39:1, 74.

Waal-Manning HJ. Metabolic effects of beta-adrenoreceptor blockers. Drugs. 1976;11 Suppl 1:121-6.

Beinart IW, Cramp DG, Pearson RM, Havard CW. The effect of metoprolol on plasma lipids. Postgrad Med J. 1979;55(648):709-11.

Pesant Y, Marc-Aurèle J, Bielmann P, Alaupovic P, Cartier P, Bichet D, et al. Metabolic and antihypertensive effects of nebivolol and atenolol in normometabolic patients with mild-to-moderate hypertension. Am J Ther. 1999;6(3):137-47.

Badar VA, Hiware SK, Shrivastava MP, Thawani VR, Hardas MM. Comparison of nebivolol and atenolol on blood pressure, blood sugar, and lipid profile in patients of essential hypertension. Indian J Pharmacol. 2011;43(4):437-40.

Peter P, Martin U, Sharma A, Dunne F. Effect of treatment with nebivolol on parameters of oxidative stress in type 2 diabetics with mild to moderate hypertension. J Clin Pharm Ther. 2006;31(2):153-9.