Sequential nephron blockade reduced SBP from 174.5 to 127.0 mmHg (p<0.0001), and dual RAS blockade plus bisoprolol reduced SBP from 178.4 to 134.4 mmHg (p<0.0001) in resistant hypertension.
RCT
Open-label
randomized, parallel-group
Does sequential nephron blockade reduce blood pressure compared to dual renin-angiotensin system blockade plus bisoprolol in patients with resistant hypertension?
Sequential nephron blockade and dual renin-angiotensin system blockade plus bisoprolol both effectively reduce blood pressure in resistant hypertension, with SNB achieving earlier SBP reduction.
p-value: p=<0.0001
Introduction: Hypertension is the most important modifiable risk factor for cardiovascular disease and a leading public health concern. Objectives: The primary aim was to compare sequential nephron blockade (SNB) versus dual renin-angiotensin system blockade (DRASB) plus bisoprolol in patients with resistant hypertension to observe reductions in systolic and diastolic blood pressure (SBP and DBP) levels after 20 weeks of treatment. Material and Methods: This trial was an open-label, prospective, randomized, parallel-group, clinical study with optional drug up-titration. Participants were evaluated during five visits at 28-day intervals. Results: The mean age was 55.5 years in the SNB and 58.4 years in the DRASB + bisoprolol group (p=NS). Significant office BP reductions were observed in both groups. SNB group, SBP decreased from 174.5±21.0 to 127.0±14.74 mmHg (p<0.0001), and DBP decreased from 105.3±15.5 to 78.11±9.28 mmHg (p<0.0001). DRASB group, SBP decreased from 178.4±21.08 to 134.4 ± 23.25 mmHg (p<0.0001) and DBP decreased from 102.7±11.07 to 77.33±13.75 mmHg (p<0.0001). Ambulatory blood pressure monitoring (ABPM) showed also significant SBP and DBP reductions in both groups (p<0.0001). Conclusion: In patients with RHTN adherent to treatment, SNB and DRASB plus bisoprolol showed excellent therapeutic efficacy, although SNB was associated with earlier SBP reduction.
Cestário et al. (Thu,) conducted a rct in Resistant hypertension. Sequential nephron blockade (SNB) vs. Dual renin-angiotensin system blockade (DRASB) plus bisoprolol was evaluated on Reductions in systolic and diastolic blood pressure (SBP and DBP) levels (p=<0.0001). Sequential nephron blockade reduced SBP from 174.5 to 127.0 mmHg (p<0.0001), and dual RAS blockade plus bisoprolol reduced SBP from 178.4 to 134.4 mmHg (p<0.0001) in resistant hypertension.
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