Celik Turgay, Yuksel U Cagdas, Iyisoy Atila, Kursaklioglu Hurkan, Ozcan Omer, Kilic Selim, Ozmen Namik, Isik Ersoy
Gulhane Military Medical Academy, School of Medicine, The Department of Cardiology Etlik, Ankara, Turkey.
Int J Cardiol. 2007 Mar 20;116(2):206-11. doi: 10.1016/j.ijcard.2006.03.046. Epub 2006 Jul 5.
We evaluated the effects of nebivolol on platelet activation in hypertensive patients by measuring mean platelet volume (MPV) and plasma soluble P-selectin (sP-sel) levels and compared with those of the patients taking metoprolol.
Eighty newly diagnosed hypertensive patients in grade 1 hypertension were enrolled in this prospective, blinded randomized study. Seventy two patients completed the study. After baseline assessment, each patient was randomly allocated to 5 mg daily dose of nebivolol (n=37, 20 male) or 100 mg daily dose of metoprolol (n=35, 18 male) and treated for 6 months. Blood pressure, heart rate, lipid profile, plasma glucose, sP-selectin levels, platelet counts and MPV were measured before and after treatment.
At the end of 6 months, nebivolol significantly decreased MPV and plasma sP-selectin levels (7.59+/-0.78 fl vs. 7.42+/-0.74 fl, p<0.001; 1.29+/-0.46 ng/ml vs. 1.21+/-0.36 ng/ml, p=0.002, respectively) compared to those of pretreatment. Although pretreatment sP-selectin levels of the two groups were similar, posttreatment plasma sP-selectin levels were significantly reduced with nebivolol compared with those of metoprolol group (1.21+/-0.36 ng/ml vs. 1.46+/-0.30 ng/ml, p=0.008). In contrast, metoprolol treatment did not cause any significant change in platelet activation parameters after treatment.
Beneficial effects of nebivolol on platelet activation were more potent than those of metoprolol. We consider that decreased platelet activation with nebivolol might play a role to reduce thrombotic risk in hypertensive patients.
通过测量平均血小板体积(MPV)和血浆可溶性P选择素(sP-sel)水平,评估奈必洛尔对高血压患者血小板活化的影响,并与服用美托洛尔的患者进行比较。
80例新诊断的1级高血压患者纳入这项前瞻性、双盲随机研究。72例患者完成了研究。在基线评估后,每位患者随机分配至每日5mg剂量的奈必洛尔组(n = 37,男性20例)或每日100mg剂量的美托洛尔组(n = 35,男性18例),并治疗6个月。在治疗前后测量血压、心率、血脂谱、血糖、sP-选择素水平、血小板计数和MPV。
6个月末,与治疗前相比,奈必洛尔显著降低了MPV和血浆sP-选择素水平(分别为7.59±0.78fl对7.42±0.74fl,p<0.001;1.29±0.46ng/ml对1.21±0.36ng/ml,p = 0.002)。虽然两组治疗前的sP-选择素水平相似,但与美托洛尔组相比,奈必洛尔治疗后血浆sP-选择素水平显著降低(1.21±0.36ng/ml对1.46±0.30ng/ml,p = 0.008)。相比之下,美托洛尔治疗后血小板活化参数未发生任何显著变化。
奈必洛尔对血小板活化的有益作用比美托洛尔更强。我们认为,奈必洛尔降低血小板活化可能在降低高血压患者血栓形成风险中发挥作用。