Introduction:
In CKD, Central blood pressure (CBP) has more relevance than Brachial blood pressure (BBP) for cardiovascular disease and ESRD progression. Non-vasodilatory beta-blockers (BB) are known to worsen Central systolic blood pressure as compared to vasodilatory BB.
Methods:
100 consecutive CKD pts (stage 1-5 ND) on a non-vasodilatory betablocker( Metoprolol(M) / Atenolol (A)/Carvedilol (C) ) amongst other antihypertensives, underwent BBP and CBP measurement with PulseCor device (suprasystolic oscillometry). 50 pts on M/A/C were substituted with Nebivolol(N) {Group A}, while 50 pts were continued on M/A/C {Group B}.
Results:
Mean duration of follow-up was 44.3 ± 13.8 days.
Impact of Nebivolol:
Systolic blood pressure amplification (mean BSBP– mean CSBP) for group A was 8.6 at visit 1 and 9.7 at visit 2 (p=0.03); whereas for group B it was 5.3 and 5.2 (p=0.6) respectively.
Mean BSBP (138 12.4 vs 141 11.4 ) and CSBP (129.1 13.6 vs 132 12.1 ) were significantly lower ( p=0.03) in those who were on N + CCB (n= 24) as compared to those on M/A/C +CCB (n=22) on visit 2.
Conclusions:
Nebivolol is more effective than non-vasodilatory beta-blockers, especially in controlling central blood pressure in CKD patients. Combining Nebivolol with Calcium channel blockers provides additional benefit.
I have no potential conflict of interest to disclose.
I did not use generative AI and AI-assisted technologies in the writing process.