Quality of life and anti hypertensive effect with nebivolol and losartan

Background: Quality of life and antihypertensive effect, two important therapeutic goals, were determined with the third generation beta-blocker nebivolol and the angiotensin receptor blocker losartan are compared. Methods: In a double-blind, randomized, parallel group study 314 patients with hypertension were treated for 12 weeks with 5 mg of nebivolol or 50 mg of losartan once daily. If after 6 weeks diastolic blood pressure (BP) was not normalized 12.5 mg of hydrochlorothiazide once daily was added. Effects of treatment were compared using analysis of variance. Results: Both drugs decreased systolic BP similarly. The decrease in diastolic BP was greater (P < .0001) with nebivolol (-12 mm Hg after 6 and 12 weeks) than with losartan (-8 and -10 mm Hg after 6 and 12 weeks, respectively). Quality of life parameters did not differ between the two treatments. This was true after 6 and 12 weeks of treatment and results did not change when corrected for different effects on BP. Aspects of quality of life including questions on sexual function did not differ between the two treatments except for headache occurring less frequently (P < .05) in patients on nebivolol monotherapy at 6 weeks. Conclusions: At advocated doses nebivolol and losartan decrease systolic BP similarly, whereas the decrease in diastolic BP was slightly greater with nebivolol. Overall quality of life parameters did not differ between nebivolol and losartan. The effect on sexual function did not differ between the two treatments and less patients had headache with nebivolol than with losartan after 6 weeks of monotherapy.