Twelve RCTs were included (n= 2,653): 11 studies were double-blind; one was single-blind.
Antihypertensive response: response rates were statistically significantly higher in nebivolol compared to ACEI groups (OR 1.92, 95% CI: 1.30, 2.85, two studies, p=0.001) and all antihypertensive drugs combined (OR 1.41, 95% CI: 1.15, 1.73, nine studies, p=0.001). There was no statistically significant difference in response rates between nebivolol and beta-blockers (three studies), CCAs (three studies) and the ARA losartan (one study).
Normalisation of BP: normalised BP rates were statistically significantly higher in nebivolol compared to losartan groups (OR 1.98, 95% CI: 1.24, 3.15, one study, p=0.004) and compared to all antihypertensive drugs combined (OR 1.35, 95% CI: 1.07, 1.72, eight studies, p=0.012) and for nebivovol compared with CCAs (OR 1.44, 95% CI: 1.05, 1.96, three studies, p=0.024). There was no statistically significant difference between nebivolol and beta-blockers (four studies).
Adverse events: there was no statistically significant difference in adverse event rates between nebivolol and placebo groups (two studies) or between nebivolol and ACEI (two studies). Adverse event rates were statistically significantly lower in nebivolol groups compared to losartan groups (OR 0.52, 95% CI: 0.30, 0.89, one study, p=0.016),other beta-blockers (OR 0.56, 95% CI: 0.36, 0.85, four studies, p=0.007), nifedipine (OR 0.49, 95% CI: 0.33, 0.72, one study, p<0.001) and all antihypertensive drugs combined (OR 0.59, 95% CI: 0.48, 0.72, eight studies, p<0.001).
Withdrawal due to adverse events: rates of withdrawal due to adverse events were statistically significantly lower in nebivolol compared to CCA groups (OR 0.18, 95% CI: 0.08, 0.41, two studies, p<0.001) and compared to all antihypertensive drugs combined (OR 0.42, 95% CI: 0.19, 0.90, seven studies, p=0.025). There were no statistically significant differences between nebivolol and ACEI (two studies), ARAs (one study) and other beta-blockers (two studies).