Nebivolol and valsartan: Useful treatment for hypertension?

摘要

In a randomised multicentre study in The Lancet, Thomas Giles and colleagues assessed the efficacy and safety of a fixed-dose combination of nebivolol and valsartan in adults with hypertension. The study's originality is in the components of the combination: a vasodilating beta blocker (nebivolol) and an angiotensin II receptor blocker (valsartan). The trial included 4l6l patients with stage 1 or 2 hypertension who were randomly assigned to receive, after completion of a 6-week single-blind placebo run-in phase, double-blind treatment with nebivolol (5 mg/day or 20 mg/day) or valsartan (80 mg/day or 160 mg/day) monotherapies, fixed-dose combinations of nebivolol and valsartan (5 and 80 mg/day, 5 and 160 mg/day, or 10 and 160 mg/day), or placebo. The doses were doubled for weeks 5-8 of the trial. The changes in seated diastolic blood pressure from baseline to week 8, the primary outcome, were significantly greater in all groups randomly assigned to fixed-dose combinations compared with those allocated to monotherapies (all p<0.0001).