Werner Timothy J, Boutagy Nabil E, Osterberg Kristin L, Rivero Jose M, Davy Kevin P
Human Integrative Physiology Laboratory, Fralin Translational Obesity Research Center, Department of Human Nutrition, Foods and Exercise, Virginia Polytechnic Institute and State University, Blacksburg, VA 24061, USA.
Ther Adv Cardiovasc Dis. 2013 Dec;7(6):285-92. doi: 10.1177/1753944713513062. Epub 2013 Nov 21.
We hypothesized that the combination of nebivolol and lifestyle modification would reduce large artery stiffness in middle-aged and older hypertensive adults more than either intervention alone.
To address this, 45 men and women (age 40-75 years) with stage I hypertension were randomized to receive either nebivolol (NB; forced titration to 10 mg OD; n = 15; age 57.2 ± 11.4 years; body mass index [BMI] 30.8 ± 5.8 kg/m(2)), lifestyle modification (LM; 5-10% weight loss via calorie restriction and physical activity; n = 15; age 52.7 ± 8.5 years; BMI 33.9 ± 7.2 kg/m(2)) or nebivolol plus lifestyle modification (NBLM; n = 15; age 58.9 ± 9.4 years; BMI 32.5 ± 4.9 kg/m(2)) for 12 weeks. β-stiffness index, a blood-pressure-independent measure of arterial stiffness, and arterial compliance were measured via high-resolution ultrasound and tonometry at baseline and after the 12-week intervention. There was no difference between groups in age, body weight or composition, blood pressure, or in β-stiffness index or arterial compliance at baseline (all p > 0.05).
Following the 12-week intervention, body weight decreased ~5% (p < 0.05) in the LM and NBLM groups but did not change from baseline in the NB group (p > 0.05). Supine brachial and carotid systolic and diastolic blood pressure declined following treatment in each of the groups (p < 0.05). However, the magnitude of reduction was not different (p < 0.05) between groups. β-stiffness index declined (-2.03 ± 0.60, -1.87 ± 0.83 and -2.51 ± 0.90 U) and arterial compliance increased similarly (both p > 0.05) in the NB, LM and NBLM groups, respectively.
In summary, our findings indicate that the combination of nebivolol and lifestyle modification reduced large artery stiffness to a similar degree as either intervention alone in middle-aged and older hypertensive adults.
我们假设奈必洛尔与生活方式改变相结合，相比于单独使用任何一种干预措施，能更有效地降低中老年高血压患者的大动脉僵硬度。
为验证这一假设，45名年龄在40 - 75岁之间的I期高血压男性和女性被随机分为三组，分别接受奈必洛尔治疗（NB组；强制滴定至每日10毫克；n = 15；年龄57.2 ± 11.4岁；体重指数[BMI] 30.8 ± 5.8 kg/m²）、生活方式改变（LM组；通过热量限制和体育活动减重5 - 10%；n = 15；年龄52.7 ± 8.5岁；BMI 33.9 ± 7.2 kg/m²）或奈必洛尔联合生活方式改变（NBLM组；n = 15；年龄58.9 ± 9.4岁；BMI 32.5 ± 4.9 kg/m²），为期12周。在基线和12周干预后，通过高分辨率超声和眼压测量法测量β僵硬度指数（一种与血压无关的动脉僵硬度测量指标）和动脉顺应性。各组在年龄、体重或组成、血压、基线时的β僵硬度指数或动脉顺应性方面均无差异（所有p > 0.05）。
经过12周干预后，LM组和NBLM组的体重下降了约5%（p < 0.05），而NB组的体重与基线相比没有变化（p > 0.05）。各组治疗后仰卧位肱动脉和颈动脉的收缩压和舒张压均下降（p < 0.05）。然而，各组间血压下降幅度没有差异（p < 0.05）。NB组、LM组和NBLM组的β僵硬度指数分别下降（-2.03 ± 0.60、-1.87 ± 0.83和-2.51 ± 0.90 U），动脉顺应性也有类似程度的增加（两者p > 0.05）。
总之，我们的研究结果表明，在中老年高血压患者中，奈必洛尔与生活方式改变相结合降低大动脉僵硬度的程度与单独使用任何一种干预措施相似。
