Makolkin V I, Akhmedova O O, Buval'tsev V I, Gavrilov Iu V, Petriĭ V V
Kardiologiia. 2003;43(2):40-3.
To compare efficacy and safety of cardioselective beta-adrenoblockers nebivolol and metoprolol in patients with hypertension and ischemic heart disease (IHD) combined with type 2 diabetes.
Patients with IHD, class II-III angina and moderately severe compensated or subcompensated type II diabetes (n=35, 29 with grade 1-2 hypertension according to WHO 1999 classification) were divided into 2 groups with similar clinical and laboratory characteristics. Patients of group 1 received metoprolol (50-100 mg/day), of group 2--nebivolol (5-7.5 mg/day) for 8 weeks. Data of physical investigation, exercise tests, 24-hour blood pressure and heart rate monitoring, analysis of lipid spectrum and glycemic profile were used for assessment of treatment efficacy.
Decrease of number of anginal attacks and nitroglycerine requirement was more pronounced in nebivolol treated patients. The use of both drugs was associated with lowering of blood pressure and heart rate. There were no unfavorable changes of parameters of carbohydrate and lipid metabolism. Pronounced (by 19.2%) lowering of triglycerides was observed in nebivolol treated patients. Both drugs were well tolerated.
Nebivolol and metoprolol are effective and safe antianginal agents in patients with IHD and hypertension combined with type 2 diabetes. However in doses used nebivolol produced more favorable metabolic and hemodynamic effects.
比较心脏选择性β-肾上腺素能阻滞剂奈必洛尔和美托洛尔在高血压合并缺血性心脏病（IHD）及2型糖尿病患者中的疗效和安全性。
将患有IHD、II-III级心绞痛且为中度严重代偿性或亚代偿性II型糖尿病的患者（n = 35，根据WHO 1999分类，其中29例患有1-2级高血压）分为两组，两组具有相似的临床和实验室特征。第1组患者服用美托洛尔（50-100毫克/天），第2组患者服用奈必洛尔（5-7.5毫克/天），疗程8周。通过体格检查、运动试验、24小时血压和心率监测、血脂谱和血糖谱分析的数据来评估治疗效果。
奈必洛尔治疗的患者心绞痛发作次数和硝酸甘油需求量的减少更为明显。两种药物的使用均与血压和心率降低有关。碳水化合物和脂质代谢参数没有不利变化。奈必洛尔治疗的患者甘油三酯明显降低（降低19.2%）。两种药物耐受性良好。
奈必洛尔和美托洛尔在IHD合并高血压及2型糖尿病患者中是有效且安全的抗心绞痛药物。然而，在所使用的剂量下，奈必洛尔产生了更有利的代谢和血流动力学效应。
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