Simova Iana Ivaylova, Todorova-Konstantinova Rumiana Radoslavova, Denchev Stefan Veselinov
Department of Noninvasive Functional and Imaging Diagnostics, National Cardiology Hospital, Sofia;
Exp Clin Cardiol. 2009 Winter;14(4):45-9.
To determine the effects of two beta-blockers, nebivolol and bisoprolol, on endothelial function in newly diagnosed hypertensive patients.
Twenty-five hypertensive patients with a mean (+/- SD) age of 45.3+/-11.5 years were randomly assigned to receive either nebivolol or bisoprolol for eight weeks in an open-label, crossover design. Flow-mediated endothelial-dependent vasodilation (FMD) was measured at baseline and after each eight-week treatment period. At the end of each treatment period, 24 h ambulatory blood pressure (BP) monitoring was performed.
The effect of the two beta-blockers on BP was similar. The mean FMD before initiation of treatment was 4.14+/-3.55%. After treatment with nebivolol, FMD increased to 8.99+/-4.21%, with a statistically significant difference from baseline (P<0.001). The effect of bisoprolol treatment on FMD was not as dramatic (3.72+/-6.84%), with no statistically significant difference from baseline. Comparing FMD after each therapeutic regimen, nebivolol treatment resulted in a marked increase in the reactivity of the brachial artery (ie, improvement of endothelial function) compared with bisoprolol treatment (P<0.001).
Nebivolol treatment of untreated hypertensive patients led to a significant improvement in endothelial function compared with bisoprolol treatment, despite the similar effect on BP with either therapeutic agent.
确定奈必洛尔和比索洛尔这两种β受体阻滞剂对新诊断高血压患者内皮功能的影响。
25例平均（±标准差）年龄为45.3±11.5岁的高血压患者，采用开放标签、交叉设计，随机分配接受奈必洛尔或比索洛尔治疗8周。在基线期以及每个8周治疗期结束后，测量血流介导的内皮依赖性血管舒张功能（FMD）。在每个治疗期结束时，进行24小时动态血压（BP）监测。
两种β受体阻滞剂对血压的影响相似。治疗开始前的平均FMD为4.14±3.55%。使用奈必洛尔治疗后，FMD增加至8.99±4.21%，与基线相比有统计学显著差异（P<0.001）。比索洛尔治疗对FMD的影响不显著（3.72±6.84%），与基线相比无统计学显著差异。比较每种治疗方案后的FMD，与比索洛尔治疗相比，奈必洛尔治疗使肱动脉反应性显著增加（即内皮功能改善）（P<0.001）。
对于未经治疗的高血压患者，与比索洛尔治疗相比，奈必洛尔治疗可使内皮功能显著改善，尽管两种治疗药物对血压的影响相似。
