Objective: To investigate and compare the endothelium-dependent vasorelaxation dynamics when administering beta–blockers carvedilol, nebivolol and calcium antagonist amlodipine to patients with essential arterial hypertension (AH)

Methods: Ninety patients with 1–2 grades AH aged 30–55 years were studied. All patients were randomized to receive carvedilol (n=45), nebivolol (n=25) and amlodipine (n=25) in initial daily doses of 25, 5 and 5 mg respectively. In two weeks if office BP level of 140/90 mmHg was not attained the dose of medicine was doubled. In four weeks in cases of uncontrolled AH the indapamide 1.5 mg was added. The length of administering period was 8 weeks. Endothelial function (EF) was evaluated with the help of flow mediated dilation (FMD) test. The ambulatory BP monitoring (ABPM) was held.

Results: An average daily dose of carvedilol, nebivolol and amlodipine amounted to 31.4±16.2, 5.7±2.4 and 6.4±2.6 mg. Mean 24-h systolic and diastolic BP significantly decreased in all groups. We also observed that the degree of brachial artery FMD reliably increased by +5.5%, +1.6% and +4.6% under the influence of carvedilol, nebivolol and amlodipine respectively. At the same time the share of patients with full recovering of EF (brachial artery FMD >10%) increased significantly only in carvedilol group – from 4.5% to 27.3% (pχ²=0.004).

Conclusion: In hypertensive patients the brachial artery endothelial function significantly increased under the influence of vasoactive antihypertensive drugs carvedilol, nebivolol and amlodipine. The greatest effect on brachial artery flow mediated dilation was observed in carvedilol group.