Comparison of the effects of nebivolol and valsartan on BP reduction and sleep apnoea activity in patients with essential hypertension and OSA

Abstract

Objectives:

To investigate the effect of nebivolol, a third generation β-blocker, on blood pressure (BP) reduction and polysomnographic parameters in hypertensive patients with mild-to-moderate obstructive sleep apnoea (OSA).

Methods:

In this double-blind, parallel group study, patients were randomized to nebivolol 5 mg or valsartan 80 mg once daily following a 14-day, placebo run-in period during which any antihypertensive medication were discontinued. BP and heart rate measurements and overnight polysomnography were performed at baseline and after 6 weeks of treatment. Safety and tolerability were assessed.

Results:

Thirty-one patients were randomized to nebivolol (n = 16) or valsartan (n = 15). After six weeks both systolic and diastolic BP were effectively reduced by both treatments. Reductions in BP were not statistically significant different between agents, but mean heart rate was significantly decreased with nebivolol (compared with valsartan (p < 0.001). There was no statistically significant difference between both treatments for the change from baseline to treatment end for mean (±SD) Apnoea Hypopnoea Index (AHI) (nebivolol: 23.0 ± 9.2 to 27.9 ± 21.2 events/h; valsartan: 23.8 ± 6.6 to 22.5 ± 18.0 events/h; p = 0.48) or for any other sleep-related parameters. Both agents were well tolerated.

Conclusion:

Nebivolol has a significant BP reduction effect in patients with OSA that is similar to valsartan and reduces heart rate to a greater extent which may prove beneficial in selected patients.

Key words:

• Beta-adrenergic blockers
• Hypertension
• Sleep apnoea

Transparency

Declaration of funding

This study was supported by a scientific grant from Berlin-Chemie AG.

Declaration of financial/other relationships

C.R. has disclosed that he has received research grants from DFG Forschungsstipendium (RE 2842/1-1). The other co-authors have nothing to disclose.

Acknowledgement

The authors have disclosed that they had no outside editorial assistance in preparing this manuscript.