Effect of Nebivolol and Olmesartan on 24-Hour Brachial and Aortic Blood Pressure in the Acute Stage of Ischemic Stroke

Eleni Georgianou; Panagiotis I Georgianos; Konstantinos Petidis; Konstantinos Markakis; Ioanna Zografou; Asterios Karagiannis

doi:10.1155/2019/9830295

Effect of Nebivolol and Olmesartan on 24-Hour Brachial and Aortic Blood Pressure in the Acute Stage of Ischemic Stroke

Int J Hypertens. 2019 Oct 7:2019:9830295. doi: 10.1155/2019/9830295. eCollection 2019.

Authors

Eleni Georgianou¹, Panagiotis I Georgianos², Konstantinos Petidis¹, Konstantinos Markakis¹, Ioanna Zografou¹, Asterios Karagiannis¹

Affiliations

¹ 2 Propedeutic Department of Medicine, Hippokration Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.
² Section of Nephrology and Hypertension, 1 Department of Medicine, AHEPA Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.

Abstract

Background: Elevated blood pressure (BP) in the acute phase of ischemic stroke is associated with heightened risk of early disability and death. However, whether BP-lowering in this setting is beneficial and the exact levels at which BP should be targeted remain unclear. This study aimed to evaluate the effect of nebivolol, olmesartan, and no-treatment on 24-hour BP in patients with hypertension during the acute poststroke period.

Methods: In a single-blind fashion, 60 patients with acute ischemic stroke and clinic systolic BP (SBP) 160-220 mmHg were randomized to nebivolol (5 mg/day), olmesartan (20 mg/day), or no-treatment between Day 4 and Day 7 of stroke onset. BP-lowering efficacy was assessed through 24-hour BP monitoring using the Mobil-O-Graph device (IEM, Germany).

Results: Between baseline and Day 7, significant reductions in 24-hour brachial SBP were noted with nebivolol and olmesartan, but not with no-treatment. Change from baseline (CFB) in 24-hour brachial SBP was not different between nebivolol and olmesartan groups (between-group difference: -3.4 mmHg; 95% confidence interval (CI): -11.2, 4.3), whereas nebivolol was superior to no-treatment in lowering 24-hour brachial SBP (between-group difference: -7.8 mmHg; 95% CI: -7.8 mmHg; 95% CI: -15.6, -0.1). Similarly, nebivolol and olmesartan equally lowered 24-hour aortic SBP (between-group difference: -1.9 mmHg; 95% CI: -10.1, 6.2). Nebivolol and olmesartan provoked similar reductions in 24-hour heart rate-adjusted augmentation index and pulse wave velocity.

Conclusion: This study suggests that during the acute phase of ischemic stroke, nebivolol is equally effective with olmesartan in improving 24-hour aortic pressure and arterial stiffness indices. ClinicalTrials.gov identifier number: NCT03655964.

Associated data

ClinicalTrials.gov/NCT03655964