Рациональная фармакотерапия в кардиологии (Dec 2015)
COMPARISON OF THE INFLUENCE OF LONG-TERM TREATMENT BASED ON CARVEDILOL OR BISOPROLOL ON METABOLIC PARAMETERS AND ERECTILE FUNCTION IN HYPERTENSIVE PATIENTS WITH OVERWEIGHT OR OBESITY RESULTS OF THE RANDOMIZED OPEN-LABEL PARALLEL-GROUPS STEPPED TRIAL CABRIOLET (PART 2)
Abstract
Aim. To compare antihypertensive and metabolic effects as well as influence on erectile function (EF) of long-term treatment with carvedilol or bisoprolol in patients with arterial hypertension (HT) of 1-2 degree and overweight/obesity. Material and methods. A total of 105 patients were enrolled into randomized, an open-label comparative stepped trial. The patients were randomized into two groups: the group 1 (n=53) started treatment with carvedilol 25 mg daily and the group 2 (n=52) – with bisoprolol 5 mg daily. If the effect was insufficient a dose of a beta-blocker was doubled, then amlodipine was added in the dose of 5 mg daily with its further increase if necessary or indapamide 1.5 mg daily addition. The follow-up for each patient was 24 weeks. At the start and then 12 and 24 weeks later the frequency of target blood pressure (BP) achievement, body mass index, biochemical indices, ECG and treatment safety were evaluated. Besides, the International Index of EF (IIEF) was calculated with the special questionnaire. Results. The effect of the treatment on BP , body mass index, biochemical parameters, indices of insulin resistance and treatment safety were presented in the first part of the article [1]. IIEF showed increase in the group 1 as compared with both baseline and its state after 12 weeks of the treatment [+2.4±5.0 (p=0.002) for all items of EF questionnaire and +0.67±2.3 (р<0.05) for the 1-5,15 items of EF questionnaire]. Patients of the group 2 showed reduction in IIEF from 12 to 24 weeks of the treatment [-1.8±7.9 (р<0.01) for all items of EF questionnaire and - 0.73±2.7 (р<0.05) for the 1-5,15 items of EF questionnaire]. There were no differences in frequency and severity of adverse events between groups. Conclusion. At similar antihypertensive efficacy , carvedilol, in contrast to bisoprolol, had not only beneficial metabolic effects, but in long-term treatment was able to improve EF in patients with HT and abdominal obesity.
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