COMPARATIVE EVALUATION OF NEBIVOLOL, BISOPROLOL, AND CARVEDILOL ON OXIDATIVE STRESS IN PATIENTS WITH HYPERTENSION.

Ksheerasagar Vinay Kumar; Pooja Tripathi Pandey; Poonam Omer; K Vijay Kumar

Authors

Ksheerasagar Vinay Kumar Associate professor, Department of Pharmacology, RVM institute of Medical Sciences & Research Center, Laxmakkapally Village, Siddipet, Telangana Author
Pooja Tripathi Pandey Associate Professor, Physiology, ASMC Shahjahanur, Uttar Pradesh. Author
Poonam Omer Associate professor and Head of department ENT, ASMC Shahjahanpur, Uttar Pradesh. Author
K Vijay Kumar Professor Department of Pharmacology, Varun Arjun Medical College and Rohilkand Hospital, Shahjahanpur, Uttar Pradesh. Author

Keywords:

Hypertension, Nebivolol, Bisoprolol, Carvedilol, Endothelial dysfunction, Oxidative stress, Metabolic syndrome

Abstract

Background: Hypertension is one of the most common long-term diseases worldwide and is a major cause of heart disease, stroke, and kidney problems. Endothelial dysfunction and oxidative stress play key roles in the development of hypertension. Among β-blockers, nebivolol, bisoprolol, and carvedilol differ in their effects on vascular function and oxidative stress. This study compares the impact of these three drugs on endothelial function, oxidative stress, and lipid profile in patients with hypertension and metabolic syndrome. Materials and Methods: This was a prospective, randomized, controlled clinical study conducted in a tertiary-care hospital over 24 months. A total of 468 patients with essential hypertension were randomly divided into three equal groups: Group A: Nebivolol 5 mg once daily, Group B: Bisoprolol 5 mg once daily and Group C: Carvedilol 6.25 mg twice daily. Patients were followed up for 60 days. Blood pressure, lipid profile, and oxidative stress markers [MDA, SOD, GPx] were measured at baseline and every 15 days. Statistical analysis was done using SPSS v25, and p < 0.05 was considered significant. Results: All three drugs reduced systolic and diastolic blood pressure significantly over 60 days [p < 0.001]. Nebivolol showed the greatest reduction in blood pressure compared to bisoprolol and carvedilol. Lipid profile also improved in all groups, but nebivolol showed a higher increase in HDL and greater reduction in total cholesterol, triglycerides, and LDL. After 60 days, nebivolol showed a significant decrease in MDA and a greater increase in antioxidant enzymes [SOD and GPx], indicating better control of oxidative stress. Liver and kidney function tests remained within normal limits in all groups. Conclusion: Nebivolol proved to be more effective than bisoprolol and carvedilol in improving endothelial function, reducing oxidative stress, and enhancing lipid profile, along with effective blood pressure control. It appears to be the most beneficial β-blocker for hypertensive patients with metabolic syndrome.