Key result
Amlodipine/Nebivolol combination therapy reduced central systolic blood pressure by 20.8 mmHg, providing comparable results to the 22.5 mmHg reduction seen with Amlodipine/Valsartan (p=0.331).
Why the study?
Pulse wave velocity and central blood pressure guide hypertension management, but the effects of a new amlodipine/nebivolol combination on these parameters compared with amlodipine/valsartan required investigation.
Does Amlodipine/Nebivolol combination therapy reduce central blood pressure and pulse wave velocity compared to Amlodipine/Valsartan in adult hypertensive patients?
RCT (n=102)
Open-label
simple 1:1 randomization
No
Does Amlodipine/Nebivolol combination therapy reduce central blood pressure and pulse wave velocity compared to Amlodipine/Valsartan in adult hypertensive patients?
Amlodipine/Nebivolol combination therapy is as effective as the established Amlodipine/Valsartan combination in reducing central blood pressure and arterial stiffness in hypertensive patients.
Supports amlodipine/nebivolol as a viable alternative to amlodipine/valsartan for central SBP reduction; extends evidence-based combination options in hypertension.
BACKGROUND: Pulse wave velocity (PWV) and central blood pressure (CBP) have been intoduced into managment of hypertensive patients. PWV is positively correlated with arterial wall stiffness while central aortic pressure becomes better predictor of cardiovascular outcome than peripheral pressure. Reduction in CBP provides protective properties against subclinical organ damage. This work aims to investigate the effect of a new combination therapy of Amlodipine/Nebivolol (A/N) on central BP, peripheral BP and PWV. The results of using this combination will be compared to the well-established fixed-dose combination of Amlodipine/Valsartan (A/V). The study conducted between October 2018 and August 2020. One hundred and two hypertensive patients were assigned for Amlodipine 10 mg/Valsartan 160 mg combination therapy (A/V, n = 52) or Amlodipine 10 mg/Nebivolol 5 mg combination therapy (A/N, n = 50) by simple 1:1 randomization. Office, central blood pressure and PWV were measured on first (0 week), second (4-8 weeks) and third visit (10-12). Difference in BP (in each arm and between arms) was calculated along all visits. RESULTS: No statistical significant difference was found between A/V and A/N regarding age, gender, BMI and CV history. OBP, CBP and PWV were significantly reduced in each arm, but no differences were found when comparing both arm results to each other. Recorded side effects were insignificant. CONCLUSIONS: The new combination therapy Amlodipine/Nebivolol (A/N) affords a significant reduction in CBP, PBP and PWV with minor and tolerable side effects. It has provided comparable results to Amlodipine/Valsartan (A/V) combination therapy.
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Sultan et al. (2022) conducted an RCT in Hypertension (n=102). Amlodipine/Nebivolol vs. Amlodipine 10 mg/Valsartan 160 mg was evaluated on Reduction in central systolic blood pressure from baseline to 10-12 weeks (p=0.331). Amlodipine/Nebivolol combination therapy reduced central systolic blood pressure by 20.8 mmHg, providing comparable results to the 22.5 mmHg reduction seen with Amlodipine/Valsartan (p=0.331).
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