Antihypertensive Efficacy of Nebivolol and Low-Dose Spironolactone in Patients with Resistant Hypertension

Objective: Resistant hypertension is associated with increased mortality and morbidity. The optimal medical therapy is not fully elucidated in resistant hypertension. There are relatively few studies in the literature on the treatment of resistant hypertension. In this study, we compared the effectiveness of nebivolol 5 mg, a third generation beta-blocker, with spironolactone 25 mg in patients with resistant hypertension. Methods: A total of 81 patients with resistant hypertension were included in the study. The spironolactone group was composed of 38 patients while the nebivolol group was composed of 43 patients. Resistant hypertension was defined as having office blood pressure >= 140/90 mmHg while the patients were under 3 or more antihypertensive agents treatment which included diuretic agents. Office and ambulatory blood pressure at basal and after 8 weeks of treatment were recorded. Results: Office systolic blood pressure and diastolic blood pressure in 24-hour ambulatory blood pressure monitoring were significantly lower when compared to basal values in both nebivolol and spironolactone groups. The decrease in 24-hour mean systolic and diastolic blood pressure in nebivolol group was 14.9 +/- 19.8 mmHg and 9.3 +/- 12.7 mmHg compared to 19.5 +/- 16.4 mmHg and 13.7 +/- 10.8 mmHg in the spironolactone group, respectively. The decrease in 24-hour mean systolic and diastolic blood pressure was not significantly different between the nebivolol and spironolactone groups (P = 0.338 and P = 0.153). Conclusion: Nebivolol is an effective treatment option for resistant hypertension and the antihypertensive effect of nebivolol is similar to low-dose spironolactone.