Comparing Beta-Blocking Effects of Bisoprolol, Carvedilol and Nebivolol

[Offcut]

Abstract

Objective: Bisoprolol, carvedilol and nebivolol have been shown to be effective in the treatment of heart failure. However, the beta-blocking effects of these drugs have never been compared directly. Methods: Therefore, we performed a randomized, double-blind, placebo-controlled, cross-over trial in 16 healthy males. Subjects received 10 mg bisoprolol, 50 mg carvedilol, 10 mg nebivolol and placebo on the first morning followed by 5 mg bisoprolol once daily, 25 mg carvedilol twice daily, 5 mg nebivolol once daily and placebo for 1 week. Heart rate and blood pressure were measured at rest and exercise 3 and 24 h following intake of the first dose, and immediately before and 3 hours following intake of the last dose of each drug. In addition, effects of the drugs on nocturnal melatonin release were determined, and quality of life (QOL) was evaluated. Results: Heart rate at exercise was decreased at 3 h following intake of the first single dose of each drug by bisoprolol (–24%), carvedilol (–17%) and nebivolol (–15%), and at 24 h following intake of the respective last dose of each drug following 1 week of chronic administration by bisoprolol (–14%), carvedilol (12 h; –15%) and nebivolol (–13%) (p < 0.05 in all cases). Thus, trough-to-peak-ratios at long-term were as follows: Bisoprolol, 58%; carvedilol (12 h), 85%; nebivolol, 91%. Nocturnal melatonin release was decreased by bisoprolol (–44%, p < 0.05) whereas nebivolol and carvedilol had no effect. QOL with carvedilol was slightly but significantly lower than with the other drugs, whereas bisoprolol and nebivolol did not alter QOL. Conclusions: These data show that peak beta-blocking effects of bisoprolol appear stronger than those of nebivolol and carvedilol. On the other hand, nebivolol exerts the highest trough-to-peak-ratio. However, beta-blocking effects of all the three drugs are similar at trough. Only bisoprolol but neither nebivolol nor carvedilol decreased nocturnal melatonin release, a feature which might cause sleep disturbances. Finally, only carvedilol slightly decreased QOL, whereas nebivolol and bisoprolol did not affect QOL. We conclude that different beta-blockers may exert clinically relevant different effects.

Source: karger.com/Article/Abstract...

[hypercat54]

Hi Offcut haven't seen you for ages and was wondering how you were. Hope you are OK. x

[Offcut in reply to hypercat54]

Still plodding on keeping a PMA. Hope you are ok too?

Be well

[hypercat54 in reply to Offcut]

Ok thanks. Apart from heavy rain and a dripping ceiling. It's like Chinese water torture.😫 x

[sassy59 in reply to hypercat54]

Oh no Bev! That’s dreadful. Xxx

[hypercat54 in reply to sassy59]

Yep. 😣 x

[sassy59 in reply to hypercat54]

Any closer to things being fixed? Labdlord needs sorting out. Xxxx

[hypercat54 in reply to sassy59]

Don't have landlord as I own the flat. There are 4 flats all owned with share of freehold. It's to do with 1 owner being difficult about a new roof and another owner who organises the insurance. However after this am going to start kicking ass x

[Offcut in reply to hypercat54]

I am a director (unpaid) of our Maintenance & Management group that deal with the car park and lawns plus 6 flats. Trying to get people to understand that the roof of the flats is everyone's problem not just those on the top floor is a nightmare.

Hope you get it sorted quickly.

[hypercat54 in reply to Offcut]

It sure is. x

[sassy59 in reply to hypercat54]

You do that Bev, it’s not right! Xxx

[Izb1]

Hi Offcut, I am on bisoprolol for fast resting heart rate and high blood pressure. Am I reading this article correctly, is it saying that bisoprolol is stronger but stops the release of melatonin causing sleep disturbance ? not very good at reading the technical jargon x

[Offcut in reply to Izb1]

That is how I have read it too. I have not slept well for years! I put it down to my stay in ICU as I had to get out of bed as soon as I woke when I was home and that went on for along time but I have also been on 10mg Bisoprolol recently dropped to 7.5mg due to my BP dropping with my PH tablets making it lower!

It is probably the cheapest one for the NHS?

BE Well

[sassy59]

Keep up that PMA Offcut. You certainly need it. Take care xxx