3Nebivolol, a vasodilatory b 1 -blocker, may be well suited for the hemodynamics of the younger hypertensive patient. In this 8-week trial, 18-to 54-year-olds with a diastolic blood pressure (DBP) of 95 mm Hg to 109 mm Hg who completed a 4-week placebo-only phase were randomized to receive nebivolol (5 mg/d, titrated to 10-20 mg/d based on achievement of blood pressure <140/90 mm Hg [n=427]) or placebo (n=214). Primary and secondary efficacy parameters were changes in trough seated DBP and systolic blood pressure (SBP), respectively. Safety parameters included adverse events (AEs). The baseline mean age was 45.3 years; SBP/DBP, 154/100 mm Hg; and heart rate, 78 beats per minute. Completion rates were 91.3% (nebivolol) and 88.3% (placebo). At endpoint, there was a significant effect of nebivolol over placebo for DBP (À11.8 mm Hg vs À5.5 mm Hg, P<.001) and SBP (À13.7 mm Hg vs À5.5 mm Hg, P<.001). Total AE rates were 34.7% (nebivolol) and 32.2% (placebo). Nebivolol monotherapy is efficacious and well tolerated in adults younger than 55 years of age with increased DBP.J Clin Hypertens (Greenwich Studies have demonstrated a positive correlation between elevated blood pressure (BP; ie, prehypertension or hypertension) at a younger age and rates of cardiovascular morbidity and mortality later in life.
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