Antihypertensive Efficacy Of Nebivolol And Low Dose Spironolactone In Patients With Resistant Hypertension

BACKGROUND
Resistant hypertension is associated with an increased mortality and morbidity. The optimal medical therapy is not fully elucidated in resistant hypertension There are very few studies in the literature on the treatment of resistant hypertension. In this study, we aimed to evaluate the effectiveness of nebivolol 5mg, the newly introduced beta blocker, by comparing it with 25 mg of spironolactone in resistant hypertension patients.

METHODS
A total of 81 patients with resistant hypertension were included in the study. The Spironolactone group was composed of 38 patients while the nebivolol group was composed of 43 patients. Resistant hypertension was defined as having office blood pressure ≥140/90 mmHg while the patients were under three or more antihypertensive agents treatment which included diuretic agent. Office and ambulatory blood pressure at basal and after 8 weeks of treatment were recorded. Descriptive statistics and tests were conducted: Student t-test, Anova, Chi-square, Mann Whitney. Statistically the significance was p <0.05.

RESULTS
Office systolic blood pressure and diastolic blood pressure in 24-h ambulatory blood pressure monitoring were significantly lower when compared to basal values in both nebivolol and spironolactone groups. The decrease in 24 h mean systolic and diastolic blood pressure in nebivolol group was 14.9±19.8 mmHg and 9.3±12.7 mmHg along with 19.5±16.4 mmHg and 13.7 ±10.8 mmHg in the spironolactone group respectively. The decrease in 24h mean systolic and diastolic blood pressure were not significant in the comparison between the nebivolol and spironolactone groups (p=0.338 and p=0.153).

CONCLUSIONS
Nebivolol is an effective treatment option in resistant hypertension and the anti-hypertensive effect of nebivolol is similar to low dose spironolactone.