[Effect of a beta 1-receptor blocker on the plasma level of atrial natriuretic peptide in patients with essential hypertension in the exercise test]

The application of nebivolol in essential hypertension: a double-blind, randomized, placebo-controlled study

This randomized, double-blind, placebo-controlled study investigated the effects of nebivolol on blood pressure, plasma renin and vasoactive hormones (aldosterone and atrial natriuretic peptide) and the heart (arrhythmias, left ventricular mass and ejection fraction) in 32 hypertensive Chinese patients aged 25-65 years. Patients received either placebo (3 men, 11 women) or nebivolol 5 mg (5 men, 13 women) once daily for 4 weeks. In the nebivolol group, a significant decrease in blood pressures (P less than 0.001) and heart rate (P less than 0.01) was seen. Nebivolol therapy also suppressed plasma renin and aldosterone concentration (P less than 0.02) but increased plasma atrial natriuretic peptide levels (P less than 0.03). No significant changes in routine blood biochemistry were demonstrated in either group. There was a tendency for left ventricular mass to decline, and left ventricular ejection fraction to rise during nebivolol therapy, but these changes did not reach statistical significance. There was no significant change in ectopic activity. None of the 32 subjects had adverse experiences requiring cessation of therapy. In conclusion, nebivolol in a dose of 5 mg daily is effective and well tolerated in patients with essential hypertension. It suppresses plasma renin and aldosterone and stimulates plasma atrial natriuretic peptide.