Sultan El-Zahraa M, Rabea Hoda, Elberry Ahmed A, Mahmoud Hesham B
Cardiology Department, Beni-Suef University Hospital, Beni-Suef City, 62511, Egypt.
Clinical Pharmacy Department, Faculty of Pharmacy, Beni-Suef University, Beni-Suef City, 62511, Egypt.
Egypt Heart J. 2022 Mar 14;74(1):15. doi: 10.1186/s43044-022-00254-0.
Pulse wave velocity (PWV) and central blood pressure (CBP) have been intoduced into managment of hypertensive patients. PWV is positively correlated with arterial wall stiffness while central aortic pressure becomes better predictor of cardiovascular outcome than peripheral pressure. Reduction in CBP provides protective properties against subclinical organ damage. This work aims to investigate the effect of a new combination therapy of Amlodipine/Nebivolol (A/N) on central BP, peripheral BP and PWV. The results of using this combination will be compared to the well-established fixed-dose combination of Amlodipine/Valsartan (A/V). The study conducted between October 2018 and August 2020. One hundred and two hypertensive patients were assigned for Amlodipine 10 mg/Valsartan 160 mg combination therapy (A/V, n = 52) or Amlodipine 10 mg/Nebivolol 5 mg combination therapy (A/N, n = 50) by simple 1:1 randomization. Office, central blood pressure and PWV were measured on first (0 week), second (4-8 weeks) and third visit (10-12). Difference in BP (in each arm and between arms) was calculated along all visits.
No statistical significant difference was found between A/V and A/N regarding age, gender, BMI and CV history. OBP, CBP and PWV were significantly reduced in each arm, but no differences were found when comparing both arm results to each other. Recorded side effects were insignificant.
The new combination therapy Amlodipine/Nebivolol (A/N) affords a significant reduction in CBP, PBP and PWV with minor and tolerable side effects. It has provided comparable results to Amlodipine/Valsartan (A/V) combination therapy.
脉搏波速度（PWV）和中心血压（CBP）已被引入高血压患者的管理中。PWV与动脉壁僵硬度呈正相关，而中心主动脉压比外周血压能更好地预测心血管结局。降低CBP可对亚临床器官损伤起到保护作用。本研究旨在探讨氨氯地平/奈必洛尔（A/N）新联合疗法对中心血压、外周血压和PWV的影响。将该联合疗法的结果与已确立的氨氯地平/缬沙坦固定剂量联合疗法（A/V）进行比较。研究于2018年10月至2020年8月进行。通过简单的1:1随机分组，将102例高血压患者分配至氨氯地平10mg/缬沙坦160mg联合疗法组（A/V，n = 52）或氨氯地平10mg/奈必洛尔5mg联合疗法组（A/N，n = 50）。在首次就诊（0周）、第二次就诊（4 - 8周）和第三次就诊（10 - 12周）时测量诊室血压、中心血压和PWV。计算所有就诊期间各治疗组内及两组间血压的差异。
在年龄、性别、BMI和心血管病史方面，A/V组和A/N组之间未发现统计学显著差异。各治疗组的诊室血压、中心血压和PWV均显著降低，但两组结果相互比较时未发现差异。记录到的副作用不显著。
新联合疗法氨氯地平/奈必洛尔（A/N）能显著降低CBP、外周血压和PWV，副作用轻微且可耐受。它与氨氯地平/缬沙坦（A/V）联合疗法的效果相当。
