Comparison of antihypertensive efficacy of carvedilol and nebivolol in mild-to-moderate primary hypertension: a randomized trial

Objective: The aim of the present study is to compare the antihypertensive effects of carvedilol and nebivolol in mild to moderate hypertensive patients. Methods: It is a prospective; placebo-controlled, cross-over, double-blind, randomized, single-center clinical trial. Patients (n=20) who were first diagnosed with mild to moderate systemic hypertension according to mean ambulatory blood pressure measurements 130/85 mmHg and no previous antihypertensive therapy were prospectively enrolled into the study. After 10 days of placebo run-in period, they were randomized within the same group as cross-over design to one month carvedilol 25 mg and one month nebivolol 5 mg regimen given once daily in the morning. The primary outcome variables were systolic and diastolic blood pressures determined by 24-hour ambulatory blood pressure measurements. Mutlivariate analysis of variance for repeated measurements with 3x2 factorial design was used for statistical analysis of results. Results: The study group consisted of 6 women and 14 men whose mean age was 42.9±12.8 years (range 19-63 years). Mean heart rate was significantly decreased after commencing both carvedilol (70.2±5.2 bpm) and nebivolol (64.9±3.9 bpm) treatments compared to placebo (78.8±5.2 bpm) (p 0.05). Both carvedilol (133.8±9/86.6±8.6 mmHg) and nebivolol (134±8.7/85.6±7.4 mmHg) significantly decreased mean systolic and diastolic blood pressures compared to placebo (143.9±8.9/94.4±9.2 mmHg), respectively (p 0.05). However, there was no significant difference in decreasing either systolic or diastolic blood pressure between nebivolol and carvedilol therapies (p 0.05). No side effects were recorded during both carvedilol and nebivolol treatments. Conclusion: Although both carvedilol and nebivolol effectively decreased blood pressure compared to placebo, they showed similar efficacy for lowering blood pressure.