Posttreatment pulse rate reduction and not baseline pulse rate as an indicator of blood pressure response to nebivolol: a subanalysis from the real-world BENEFIT-KOREA study

Background: This subanalysis of BENEFIT-KOREA cohort assessed the impact of baseline pulse rate (PR) and posttreatment PR reduction on the blood pressure (BP)-lowering efficacy of nebivolol in patients with hypertension.Methods: South Korean patients with hypertension were enrolled in the BENEFIT-KOREA study; 3,011 patients received nebivolol as monotherapy/add-on therapy.Time-averaged BP, calculated by sum of the product of BPs at weeks 12 and 24 corrected for number of participants at these timepoints, was evaluated with/without adjustment for baseline BP.Change in BP in baseline PR groups of < 70, 70-79, and ≥ 80 beats/min and posttreatment PR reduction groups of < 1, 1-9, and ≥ 10 beats/min at 24 weeks were evaluated.Results: The unadjusted time-averaged systolic BP (SBP) at 24 weeks was not significantly different within baseline PR groups or posttreatment PR reduction groups, but the unadjusted time-averaged diastolic BP (DBP) was significantly different within both baseline PR (P < 0.001) and posttreatment PR reduction groups (P < 0.001).Significant differences were observed in adjusted time-averaged SBP (≥ 10 beats/min group: β, -3.4148; P = 0.006) and time-averaged DBP (≥ 10 beats/min: β, -4.5781; P < 0.001) only within the posttreatment PR reduction groups.The majority of adverse events reported with nebivolol were mild.Conclusions: The efficacy of nebivolol for BP reduction seems to be indicated not by baseline PR but by posttreatment PR reduction.These findings suggest the presence of other