Nebivolol Reduces Symptoms of Cardiac Arrhythmias in Patients with Arterial Hypertension: An Observational Pilot Study

Journal of Clinical and Basic Cardiology 2006; 9 (1-4): 27-30

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Keywords: Arrhythmie,  Hypertonie,  Nebivolol,  arrhythmia,  hypertension

Betablockers are widely recommended in the treatment of arterial hypertension. Many clinical trials have investigated these drugs under various aspects of anti-hypertensive action and outcome. Despite their pharmacology being well-understood, the exact mechanism by which their antihypertensive action is unfolded remains an open question. Nebivolol is a rather new third-generation betablocker with very pronounced cardioselectivity and additional features such as NO-dependent vasodilation. It has been used successfully in the treatment of patients with arterial hypertension and congestive heart failure. Betablockers, in fact, have long been regarded as effective agents for supra-ventricular and ventricular arrhythmias. Betablockers as a class show multiple anti-arrhythmic mechanisms such as various membrane-stabilising effects and they limit spontaneous depolarisation. Nebivolol, too, exhibits a remarkable anti-arrhythmic potential. However, there have been few attempts to explore and use it therapeutically. In this observational pilot study, we assess the anti-hypertensive effect of nebivolol in patients treated for arterial hypertension. In 62 subjects, we found that after 67 ± 4 (± SEM) days of treatment, systolic blood pressure was reduced from 154 ± 3 mmHg to 140 ± 3 mmHg and diastolic pressure was reduced from 86 ± 2 mmHg to 79 ± 2 mmHg. Besides, we studied the effect of nebivolol upon arrhythmiarelated symptoms in hypertensive patients and found that palpitations present in 81 % of all patients at the beginning of the study were seen in only 13 % of all participants after 67 days of treatment. Similar findings were made concerning symptoms of tachyarrhythmias: 47 % at the beginning, 3 % of all patients at the last visit. Despite the limitations of this study being non-randomised and observational, we conclude that nebivolol exerts a satisfactory antihypertensive effect and helps to reduce symptoms usually related to arrhythmias. This special feature of nebivolol may render the drug particularly helpful in patients with arterial hypertension complaining about symptoms related to arrhythmias.