Key result
Nebivololum and sotalolum comparably controlled hypertension and atrial fibrillation, but nebivololum was deemed preferable due to its positive impact on regulatory adaptive status.
Why the study?
The comparative effectiveness of nebivololum versus sotalolum in patients with hypertensive disease stages II-III and paroxysmal atrial fibrillation considering regulatory adaptive status was unclear.
Does nebivolol compared to sotalol improve regulatory adaptive status and clinical outcomes in patients with hypertensive disease and paroxysmal atrial fibrillation?
RCT (n=50)
randomized
Does nebivolol compared to sotalol improve regulatory adaptive status and clinical outcomes in patients with hypertensive disease and paroxysmal atrial fibrillation?
In patients with hypertension and paroxysmal atrial fibrillation, nebivolol may be preferable to sotalol as part of combination therapy due to its positive effects on regulatory adaptive status.
May favor nebivolol over sotalol for RAS effects in HD with paroxysmal AF; leaves open confirmation in larger trials.
Aim: compare the effectiveness of treatment with nebivololum or sotalolum in patients with hypertensive disease (HD) and paroxysmal atral fibrillation (AF) taking into account quantitative evaluation of the regulatory adaptive status (RAS). Materials and methods. 50 patients with HD of stages II-III and paroxysmal AF took part in the research, they were randomized into two groups for treatment with nebivololum (5.6±1.6 mg/day n=25) or sotalolum (157.0±38.3 mg/day, n=25). As part of combination therapy, patients were administered lisinoprilum (14.3±3.7 mg/day and 14.4±3.9 mg/day), when required alsoatorvastatinum (18.8±4.4 mg/day, n=11 and 16.0±5.1 mg/day, n=12), acetylsalicylic acid (91.2±14.1 mg/day, n=11and 92.1±16.8 mg/day, n=11), respectively. Initially and 6 months after therapy, the following was done: quantitative assessment of RAS (by cardio-respiratory synchronism test), echocardiography, triplex scanning of brachiocephalic arteries, treadmill test, six-minute walk test, all-day monitoring of blood pressure and electrocardiogram, subjective assessment of quality of life. Results. Both drug regimens comparably improved structural and functional condition of the heart, controlled arterial hypertension, effectively suppressed paroxysms of AF, improved the quality of life. At the same time, the use of nebivololum increased the RAS and increased exercise tolerance, to a lesser degree than the use of sotalolum. Conclusion. In patients with HD of stages II-III and paroxysmal AF the use of nebivololum as part of combination therapy may be preferable to sotalolum due to its positive impact on the RAS.
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Eremina et al. (2016) conducted an RCT in Hypertensive disease and paroxysmal atrial fibrillation (n=50). Nebivololum vs. Sotalolum was evaluated on Regulatory adaptive status (RAS). Nebivololum and sotalolum comparably controlled hypertension and atrial fibrillation, but nebivololum was deemed preferable due to its positive impact on regulatory adaptive status.
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