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

Abstract

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 vascu
lar function and oxidative stress. This study compares the impact of these three drugs on endothelial function, oxida
tive 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 base
line 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]. Nebivo
lol 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 en
zymes [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 im
proving endothelial function, reducing oxidative stress, and enhancing lipid profile, along with effective blood pres
sure control. It appears to be the most beneficial β-blocker for hypertensive patients with metabolic syndrome.