russjcardiolРоссийский кардиологический журналRussian Journal of Cardiology1560-40712618-7620«SILICEA-POLIGRAF» LLCrussjcardiol-1752Research ArticleКЛИНИКА И ФАРМАКОТЕРАПИЯGUIDELINES FOR THE PRACTITIONERВЛИЯНИЕ β-АДРЕНОБЛОКАТОРОВ - НЕБИВОЛОЛА И НАДОЛОЛА НА ПОКАЗАТЕЛИ ЛИПИДНОГО, УГЛЕВОДНОГО ОБМЕНА И ИНСУЛИНРЕЗИСТЕНТНОСТЬ У БОЛЬНЫХ ГИПЕРТОНИЧЕСКОЙ БОЛЕЗНЬЮ С ИЗБЫТОЧНОЙ МАССОЙ ТЕЛАEFFECTS OF NEBIVOLOL VS NADOLOL ON GLUCOSE AND LIPID METABOLISM IN OVERWEIGHT HYPERTENSIVE PATIENTS. A OPEN RANDOMIZED CONTROLLED STUDYБернгардтЭ. Р.BerngardtE. R.КонрадиА. О.KonradyA. O.СмирноваЕ. В.SmirnovaE. V.ШляхтоЕ. В.ShliahtoE. V.Санкт-Петербургский государственный медицинский университета им. акад. И.П. Павлова; Институт сердечно-сосудистых заболеванийRussian Federation200328062003034954Copyright © Бернгардт Э.Р., Конради А.О., Смирнова Е.В., Шляхто Е.В., 20032003Бернгардт Э.Р., Конради А.О., Смирнова Е.В., Шляхто Е.В.Berngardt E.R., Konrady A.O., Smirnova E.V., Shliahto E.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://russjcardiol.elpub.ru/jour/article/view/1752Цель

Цель. Изучить эффекты бета-адреноблокаторов с вазодилатирующими свойствами и без таковых на состояние углеводного и липидного обменов у больных артериальной гипертонией (AT) и избыточной массой тела.

Материал и методы

Материал и методы. В исследование включены 24 пациента с AT, которые были рандомизированы на 2 группы лечения. Первая группа получала небиволол в дозе 5-10 мг в сутки, а вторая - надолол 80-240 мг в сутки в течение 6 месяцев. Выполнялся тест на толерантность к глюкозе (ТТГ), липидный спектр и суточное мониторирование артериального давления (СМАД) исходно и в конце периода лечения.

Результаты

Результаты. В группе больных, получавших небиволол, отмечено уменьшение площади под кривой инсулина и уменьшение инсулинорезистентности, тогда как в группе больных, использовавших надолол, не получено существенных изменений в показателях ТТГ. Показатели липидограммы несколько ухудшались на фоне лечения надололом и улучшились при терапии небивололом.

Заключение

Заключение. Лечение бета-блокатором с вазодилатирующими свойствами небивололом у больных AT и избыточной массой тела сопровождается улучшением состояния углеводного и липидного обменов, тогда как длительная терапия у таких пациентов неселективным препаратом надололом ухудшает липидный спектр крови. Такие результаты имели место на фоне сопоставимой антигипертензивой эффектвности препаратов.

Objective

Objective. The aim of the present study was to assess effects of treatment of overweight hypertensive patients with vasodilatating and non-vasodilatating beta-blockers on glucose and lipid metabolism.

Patients and methods

Patients and methods. 24 patients with mild to moderate hypertension were randomised into two treatment groups - nebivolol 5-10 mg per day vs nadolol 80-240 mgper day and treated for 6 months. Oral glucose tolerance test (OGTT) with the measurement of glucose and insulin levels: fasting, 30, 60, 90 and 120 minutes of test were performed initially and at the end of the study. Lipid profile and ambulatory blood pressure monitoring were also assessed for all patients.

Results

Results. Antihypertensive effect was comparable in both groups. At the same time, nebivolol improved parameters of OGTT and reduced insulin resistance, while in nadolol group these parameters remained unchanged. Lipid profile improved during nebivolol treatment and slightly worsened in nadolol group.

Conclusion

Conclusion. Long-term nebivolol treatment can improve glucose tolerance and lipid spectrum in overweight patients, while administration of nadolol can slightly worsen lipid metabolism. These effects are unrelated to antihypertensive action of the drugs, which is comparable.

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The authors declare that there are no conflicts of interest present.