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Meta-Analysis
. 2020 Oct;48(10):300060520931625.
doi: 10.1177/0300060520931625.

Efficacy and safety of nebivolol in hypertensive patients: a meta-analysis of randomized controlled trials

Jun-Ying Liu  1 , Li-Na Guo  2 , Wan-Zhong Peng  1 , Yang Jiang  1 , Ai-Li Wang  1 , Xue-Min Guo  1 , Ze-Sheng Xu  1
Affiliations
Meta-Analysis

Efficacy and safety of nebivolol in hypertensive patients: a meta-analysis of randomized controlled trials

Jun-Ying Liu et al. J Int Med Res. 2020 Oct.

Abstract

Purpose: Our meta-analysis was undertaken to evaluate the efficacy and safety of nebivolol compared with other second-generation β blockers for hypertensive patients.

Methods: We searched PubMed, the Cochrane Library, EMBASE, and Clinical Trials.gov databases for randomized controlled trials (RCTs). The efficacy endpoints included systolic blood pressure (SBP), diastolic blood pressure (DBP), reduction of SBP and DBP, heart rate (HR), and adverse events (AEs).

Findings: Eight RCTs with 1514 patients met the inclusion criteria. HR was significantly lower in patients receiving other second-generation β blockers compared with patients receiving nebivolol. There was no difference the reduction of blood pressure (SBP and DBP) or the reduction of SBP or DBP between the groups. The incidence of AEs was lower in patients taking nebivolol compared with patients taking other second-generation β blockers.

Conclusions: No significant difference was demonstrated between nebivolol and other second-generation β blockers in the reduction of blood pressure, SBP, and DBP. The tolerability of nebivolol was significantly better compared with other second-generation β blockers, and nebivolol was also associated with a stable HR and a lower risk of AEs compared with other second-generation β blockers.

Keywords: Nebivolol; adverse events; diastolic blood pressure; heart rate; hypertension; meta-analysis; systolic blood pressure; β blocker.

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Conflict of interest statement

The authors declare that there is no conflict of interest.

Figures

Figure 1.
Figure 1.
Flowchart of literature retrieval and selection.
Figure 2.
Figure 2.
Forest plot of the reduction in blood pressure. WMD represents the difference between the reduction of blood pressure in nebivolol-treated patients and the control patients who were treated with other second-generation β blockers. The green squares represent the point estimation of WMD in each individual study and the size of the square reflects the weight of this study. The black squares represent the point estimation and 95%CI of overall WMD. SBP, systolic blood pressure; DBP, diastolic blood pressure; SD, standard deviation; IV, inverse-variance; 95%CI, 95% confidence interval; Fixed, fixed effects model; df, degrees of freedom; WMD, mean difference.
Figure 3.
Figure 3.
(a). Forest plot of systolic blood pressure. WMD represents the difference between the systolic blood pressure value in nebivolol treated patients and the control patients who were treated with other second generation β blockers. The green squares represent the point estimation of WMD in each individual study and the size of the square reflects the weight of this study. The black squares represent the point estimation and 95%CI of overall WMD. (b) Forest plot of diastolic blood pressure. WMD represents the difference between the diastolic blood pressure value in nebivolol treated patients and the control patients who were treated with other second-generation β blockers. The green squares represent the point estimation of WMD in each individual study and the size of the square reflects the weight of this study. The black squares represent the point estimation and 95%CI of the overall WMD. DBP, diastolic blood pressure; SD, standard deviation; IV, inverse-variance; 95%CI, 95% confidence interval; Fixed, fixed effects model; df, degrees of freedom; WMD, mean difference.
Figure 4.
Figure 4.
(a). Forest plot of HR. WMD represents the difference between the HR in nebivolol treated patients and the control patients who were treated with other second generation β blockers. The green squares represent the point estimation of WMD in each individual study and the size of the square reflects the weight of this study. The black squares represent the point estimation and 95%CI of overall WMD. (b) Forest plot of AEs. The RR represents the difference between the AE rate in nebivolol treated patients and the control patients who treated with other second generation β blockers. The green squares represent the point estimation of RR in each individual study and the size of the square reflects the weight of this study. The black squares represent the point estimation and 95%CI of overall RR. SD, standard deviation; IV ,inverse-variance; 95%CI, 95% confidence interval; Fixed, fixed effects model; df, degrees of freedom; WMD, mean difference; RR, risk ratio; AEs, adverse events; M-H, Mantel–Haenszel; Events, number of the participant that experienced at least one adverse effect.
Figure 5.
Figure 5.
Sensitivity analysis. Lower CI limit, lower limit of 95%CI; Upper CI limit, upper limit of 95%CI; 95%CI, 95% confidence interval.
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