Nebivolol, Hydrochlorothiazide Combo Improves Blood Pressure Better Than Irbesartan in the Elderly

By Frances Morin

MILAN, Italy -- June 18, 2015 -- The antihypertensive combination of nebivolol and hydrochlorothiazide shows greater reductions in 24-hour systolic blood pressure in elderly patients, compared with irbesartan plus hydrochlorothiazide, researchers reported here at the 25th Scientific Meeting of the European Society of Hypertension (ESH) on Hypertension and Cardiovascular Protection.

Combined drug therapies are recommended in for the treatment of isolated systolic hypertension (ISH) in helping to control blood pressure in older adults.

In an effort to compare the efficacy of two anti-hypertensive combinations, Guido Grassi, MD, Clinica Medica, Università Milano-Bicocca, Ospedale San Gerardo, Monza, Italy, and colleagues randomised 124 patients with isolated systolic hypertension to treatment with nebivolol 5 mg plus hydrochlorothiazide 12.5 mg (NH, n = 62) or irbesartan 150 mg and hydrochlorothiazide 12.5 mg (IH, n = 62) once daily for 12 weeks. Patients had a median age of 69 years.

Results showed a significantly greater reduction in sitting systolic blood pressure in the NH group compared with the IH group after 12 weeks (25.8 ± 1.6 vs 20.6 ± 1.7mm Hg; P < .03) as well as in heart rate (HR, 7.0 ± 1.0 vs 2.5 ± 1 b/min; P < .01).

The NH group meanwhile showed a non-significantly greater decrease in diastolic and pulse blood pressure than the IH group (7.4 ± 1.0 and 18.3 ± 1.5 vs 5.0 ± 0.09 and 15.7 ± 1.7 mm Hg).

The degree of reduction in 24-hour, daytime and night-time systolic blood pressure was nearly the same in both groups, but the NH group had a greater heart rate reduction at all time-points compared with the IH group (P < .001).

The NH group also showed significantly greater reductions in 24-hour systolic blood pressure variability compared with the IH group when expressed as standard deviation (4.4 ± 2.7 vs 2.2 ± 5.1 mm Hg; P < .02) as well as a coefficient of variation (2.0 ± 2.6 vs 0.3 ± 3.4; P < .01).

[Presentation title: Multicentre Randomised, Double Blind, Evaluation of Nebivolol Plus HCTZ and Irbesartan Plus HCTZ in the Treatment of Isolated Systolic Hypertension in the Elderly: The NEHIS Study. Abstract 9C.07]
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