Open AccessBlood Pressure Effects of Combined β‐Blocker and Angiotensin‐Converting Enzyme Inhibitor Therapy Compared With the Individual Agents: A Placebo‐Controlled Study With Nebivolol and Lisinopril
Author(s) -
Weber Michael A.,
Basile Jan,
Stapff Manfred,
Khan Barbara,
Zhou Dongli
Publication year - 2012
Publication title -
the journal of clinical hypertension
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.909
H-Index - 67
eISSN - 1751-7176
pISSN - 1524-6175
DOI - 10.1111/j.1751-7176.2012.00666.x
Subject(s) - lisinopril , nebivolol , medicine , blood pressure , placebo , ace inhibitor , angiotensin converting enzyme , endocrinology , pharmacology , alternative medicine , pathology
J Clin Hypertens (Greenwich) . 2012; 14:588–592. © 2012 Wiley Periodicals, Inc. Blood pressure (BP) reductions when combining blockers of the renin‐angiotensin system (RAS) and β‐blockers have generally not been shown to be greater than for individual agents, possibly because of overlapping mechanisms of action. The authors tested the additivity of the β‐blocker nebivolol, which has vasodilating activity, with the angiotensin‐converting enzyme inhibitor lisinopril in patients with stage 2 diastolic hypertension. The BP effects of placebo (n=93), nebivolol 5 mg to 20 mg daily (n=185), lisinopril 10 mg to 40 mg daily (n=189), and nebivolol 5 mg to 20 mg + lisinopril 10 mg to 40 mg (n=189) during 6 weeks of treatment were compared. The primary end point was change in diastolic BP (DBP). For the full cohort, baseline BP was 163.8/104.4 mm Hg, mean age was 49.2 years, 58% were men, 62% were white, and 34% were black. DBP fell by 17.2±10.2 mm Hg with the combination, greater than placebo (8.0±9.2, P <.0001), nebivolol (13.3±8.9, P =.0010), and lisinopril (12.0±9.8, P <.0001). For systolic BP, corresponding reductions were 19.2±19.8 mm Hg, 9.9±16.4 ( P <.0001 vs combination), 14.4±14.1 ( P =.0470), and 16.1±17.2 ( P =.0704). Adverse event rates were similar in all groups. This study demonstrated the potential antihypertensive benefits of combining nebivolol with a RAS blocker.