Introduction: ESC/ISH guidelines suggest the use of fixed dose combination from the beginning in the therapy of the essential arterial hypertension because fixed dose combination ensures a better and quicker thera-peutic effect, with diminished adverse effects and the simplification of therapy. High blood pressure is asso-ciated with left ventricular hypertrophy and diastolic dysfunction. High pulse pressure is a marker of central arterial stiffness and a predictor for mortality.
Objective: The aim of our study was to evaluate the efficacy of the fixed dose combination nebivolol/hydro-chlorthiazide 5/12.5 mg (N/H) on BP, pulse pressure, left ventricular hypertrophy and diastolic dysfunction in elderly patients (over 65 years old) with first and second degree arterial hypertension.
Methods: We performed a prospective study, lasting 3 months, in which 28 never- treated old hypertensives grade 1 and 2, with high pulse pressure (≥60 mmHg), medium age 71±5 years, received once daily fixed com-bination N/H. The assessment of echocardiographic parameters of left ventricle was performed at baseline and after 3 months of treatment. Office blood pressure and pulse pressure ware monitored every month.
Results: Blood pressure was significantly reduced by treatment, both systolic (168±21 vs. 135±12 mmHg, p<0.01) and diastolic (98±11 vs. 87±12 mmHg, p<0.01). Pulse pressure decreased from 66±21 mmHg to 61±18 mmHg (p<0.03). LVMI was decreased from135.5±15 to 113.1±13.6 g/m² (p<0.001). E/A ratio increased from 0.98±0.04 to 1.20±0.05 (p<0.05). Treatment was well tolerated.
Conclusions: Fixed-dose combination nebivolol/hydrochlortiazide in mild to moderate old hypertensives with high pulse pressure produced a good control of BP, a reduction of office pulse pressure and a regression of cardiac hypertrophy with improvement in LV dias-tolic function.