Author + information
- Brent Egan,
- Alan Gradman,
- Sanjida Ali,
- Qian Li,
- Mehul Patel and
- Jan Basile
Introduction: β-blockers reduce risk of cardiovascular (CV) events, but comparative CV event risk between the vasodilatory β1-selective antagonist/β3 agonist nebivolol and non-vasodilatory β1-blockers atenolol and metoprolol is unknown.
Objective: To compare hospitalization risk due to CV events in nebivolol, atenolol or metoprolol-treated patients with hypertension (HTN).
Methods: Incident nebivolol (mean dose=7.4 mg/d), atenolol (45.2 mg/d) or metoprolol (57.1 mg/d) monotherapy users with HTN were identified via US claims data (2007-2014). First β-blocker claim on/after 1/1/2008 defined index drug and date. A pairwise propensity score approach matched treatment cohorts (N=27,134 each) across the following characteristics: baseline demographics, Charlson Comorbidity Index, diabetes, rheumatic, renal and chronic pulmonary diseases, baseline anti-HTN drug use, and treatment duration. The primary outcome was hospitalization risk for composite CV outcome (MI, CHF, stroke, angina) assessed by Cox proportional hazards regression, adjusted for the variables above.
Results: Metoprolol and atenolol users had 68% and 105% higher hospitalization risk for composite CV events vs nebivolol. Hospitalization risk for component events was significantly lower with nebivolol except for stroke and CHF vs atenolol and stroke vs metoprolol (Figure 1).
Conclusions: Nebivolol monotherapy was associated with lower CV-related hospitalization risk than atenolol and metoprolol.
Poster Hall, Hall C
Friday, March 17, 2017, 10:00 a.m.-10:45 a.m.
Session Title: Assessing the Clinical Impact of Blood Pressure Lowering Therapies
Abstract Category: 33. Prevention: Hypertension
Presentation Number: 1105-036
- 2017 American College of Cardiology Foundation