Vaz-de-Melo Renan Oliveira, Giollo-Júnior Luiz Tadeu, Martinelli Débora Dada, Moreno-Júnior Heitor, Mota-Gomes Marco Antônio, Cipullo José Paulo, Yugar-Toledo Juan Carlos, Vilela-Martin José Fernando
Hospital de Base, Faculdade de Medicina de São José do Rio Preto, São Paulo, Brazil.
Department of Internal Medicine, Cardiovascular Pharmacology Laboratory, School of Medical Sciences, Universidade Estadual de Campinas, Campinas, São Paulo, Brazil.
Sao Paulo Med J. 2014;132(5):290-6. doi: 10.1590/1516-3180.2014.1325704. Epub 2014 Jul 22.
Assessment of central blood pressure (BP) has grown substantially over recent years because evidence has shown that central BP is more relevant to cardiovascular outcomes than peripheral BP. Thus, different classes of antihypertensive drugs have different effects on central BP despite similar reductions in brachial BP. The aim of this study was to investigate the effect of nebivolol, a β-blocker with vasodilator properties, on the biochemical and hemodynamic parameters of hypertensive patients.
Experimental single cohort study conducted in the outpatient clinic of a university hospital.
Twenty-six patients were recruited. All of them underwent biochemical and hemodynamic evaluation (BP, heart rate (HR), central BP and augmentation index) before and after 3 months of using nebivolol.
88.5% of the patients were male; their mean age was 49.7 ± 9.3 years and most of them were overweight (29.6 ± 3.1 kg/m2) with large abdominal waist (102.1 ± 7.2 cm). There were significant decreases in peripheral systolic BP (P = 0.0020), diastolic BP (P = 0.0049), HR (P < 0.0001) and central BP (129.9 ± 12.3 versus 122.3 ± 10.3 mmHg; P = 0.0083) after treatment, in comparison with the baseline values. There was no statistical difference in the augmentation index or in the biochemical parameters, from before to after the treatment.
Nebivolol use seems to be associated with significant reduction of central BP in stage I hypertensive patients, in addition to reductions in brachial systolic and diastolic BP.
近年来,对中心血压(BP)的评估有了显著发展,因为有证据表明,中心血压比外周血压与心血管结局的相关性更强。因此,尽管不同类别的降压药对肱动脉血压的降低幅度相似,但它们对中心血压的影响却有所不同。本研究的目的是探讨具有血管舒张特性的β受体阻滞剂奈必洛尔对高血压患者生化和血流动力学参数的影响。
在一家大学医院的门诊进行的实验性单队列研究。
招募了26名患者。所有患者在使用奈必洛尔3个月前后均接受了生化和血流动力学评估(血压、心率(HR)、中心血压和增强指数)。
88.5%的患者为男性;他们的平均年龄为49.7±9.3岁,大多数人超重(29.6±3.1kg/m²),腹部腰围较大(102.1±7.2cm)。与基线值相比,治疗后外周收缩压(P = 0.0020)、舒张压(P = 0.0049)、心率(P < 0.0001)和中心血压(129.9±12.3 vs 122.3±10.3mmHg;P = 0.0083)均显著降低。治疗前后增强指数或生化参数无统计学差异。
奈必洛尔似乎与I期高血压患者中心血压的显著降低有关,同时还能降低肱动脉收缩压和舒张压。