Hypertension is one of the components of metabolic syndrome (MS) and risk factor for cardiovascular disease (CVD). Hypertensive patients with stable angina (SA) and MS are especially considered a major risk for developing CVD complications. The aim of this study was to evaluate the efficacy of beta – blocker nebivalol alone or in combination with metabolic agent trimetazidine in hypertensive patients with MS and SA.Design and Method:
Forty eight mild to moderate hypertensive patients with MS and documented coronary artery disease (CAD), aged 52 – 65 years, were randomly assigned to nebivalol 2.5 mg daily (group A-24 patients) and nebivalol 2.5 mg daily with trimetazidine MR 35 mg twice daily (group B-24 patients). Anthropometric data, Echocardiography and treadmill exercise tests were performed at baseline and after 6 months of therapy.Results:
At the end of the study systolic BP was lowered in both groups to less than 140 mmHg. LV mass index reduced from 153.7 ± 7.2 to 123.4 ± 3.2 g/m2 with nebivalol and from 154.9 ± 7.2 to 122.3 ± 2.9 g/m2 with nebivalol and trimetazidine MR in combination (p < 0.02 for both groups). At the end of the study time to 1 mm ST segment depression compared to baseline increased by 12.5 % in group A (p < 0.05) and by 16.7 % in group B (p < 0.002). Maximum ST segment depression compared to baseline passed by 8.3 % in group A (p < 0.02) and by 16.6 % in group B (p < 0.002). Mean number of anginal attacks per week decreased by 25.0 % vs 33.3 % respectively (p < 0.001).Conclusions:
Combination therapy produced significant improvements in exercise stress tests and reduced clinical symptoms in patients MS and CAD.