Nebivolol - b-bloker different than others. The results of SENIORS trial Review article
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Abstract
Nebivolol has the highest β1-receptor affinity with vasodilating properties related to endothelial nitric oxide synthase activation. Impaired endothelial function has a major causal role in the pathophysiology of chronic heart failure. The endothelium-agonistic properties of nebivolol suggest that this drug might provide additional benefit beyond β-receptor blockade. Large trials of β-blockers in heart failure enrolled subjects younger than the real-world heart failure population. The patients with an ejection fraction >40% were excluded. The SENIORS study was undertaken to determine the effect of nebivolol on mortality and morbidity in elderly patients >70 years with heart failure, regardless of ejection fraction. The primary outcome (composite of all cause mortality or cardiovascular hospital admission) occured in 31,1% patients on nebivolol compared with 35,3% on placebo (HR=0,86; 95% CI: 0,74–0,99; p=0,039). There was no significant influence of age, gender or ejection fraction on the effect of nebivolol on the primary outcome. Nebivolol, a β1-blocker with vasodilating properties, is an effective and well-tolerated treatment for heart failure in the elderly.
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