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Background <p>Hypertension is considered the world’s leading risk factor for mortality. Many individuals with hypertension need to take multiple blood pressure (BP)-lowering medications. Combining Nebivolol, a third-generation beta-blocker, and Valsartan, an angiotensin receptor blocker (ARB), presents a promising therapeutic approach for BP management. Although several clinical studies have evaluated this combination, evidence regarding its overall efficacy and safety remains fragmented. This study aims to evaluate the efficacy and safety of this combination therapy.</p> Method <p>The systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A systematic literature search was conducted across PubMed, Scopus, and the Cochrane Library from inception until February 2025. The studies that met the requirements to assess the safety and effectiveness of a combination therapy of nebivolol and valsartan for the treatment of hypertension included open-label studies, crossover trials, and randomized controlled trials (RCTs). Databases searched included PubMed, Scopus, and Cochrane Library. The main topics of data extraction were the changes in systolic and diastolic blood pressure (SBP/DBP), cardiovascular events, treatment adherence, and quality-of-life measures. The risk of bias was assessed using ROB 2.0 and ROBINS-I frameworks.</p> Results <p>Out of 99 initially screened studies, six met the inclusion criteria, including two randomized controlled trials (one of which generated two prespecified sub-analyses), one open-label single-arm study, and one crossover trial. The results showed that combining Nebivolol and valsartan decreased SBP and DBP. The highest dose (20/320&#xa0;mg) achieved a mean SBP reduction of -15.4 mmHg and a DBP reduction of -10.0 mmHg over 8 weeks. Long-term Studies of a 52-week duration showed sustained blood pressure control, with an average drop in SBP of -25.5 mmHg and a drop in DBP of -19.0 mmHg. Additionally, the combination improved heart rate variability and reduced renin-angiotensin-aldosterone system activity. Clinical trials have reported that Nebivolol has a favorable safety profile, with mild and transient symptoms, including fatigue, headache, dyspnea, insomnia, dizziness, and paresthesia, making it a patient-preferred option.</p> Conclusion <p>This systematic review provides evidence for the safety and efficacy of the nebivolol-valsartan combination as an antihypertensive regimen. The combination is also beneficial in terms of hemodynamic parameters and overall cardiac load. Nevertheless, large-scale, long-term trials are needed to confirm these results and to define who can benefit most from this therapy.</p>

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Exploring the benefits and safety of combining nebivolol and valsartan for managing hypertension: a systematic review

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年5月30日

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  • Mohamed Khalid,
  • Wojoud M. Majzoub,
  • Yasmeen M. Ibrahim,
  • Hatoon Makki,
  • Esraa Ibrahim,
  • Manar M. Amin,
  • Kannan O. Ahmed,
  • Bashir A. Yousef

摘要

Background

Hypertension is considered the world’s leading risk factor for mortality. Many individuals with hypertension need to take multiple blood pressure (BP)-lowering medications. Combining Nebivolol, a third-generation beta-blocker, and Valsartan, an angiotensin receptor blocker (ARB), presents a promising therapeutic approach for BP management. Although several clinical studies have evaluated this combination, evidence regarding its overall efficacy and safety remains fragmented. This study aims to evaluate the efficacy and safety of this combination therapy.

Method

The systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A systematic literature search was conducted across PubMed, Scopus, and the Cochrane Library from inception until February 2025. The studies that met the requirements to assess the safety and effectiveness of a combination therapy of nebivolol and valsartan for the treatment of hypertension included open-label studies, crossover trials, and randomized controlled trials (RCTs). Databases searched included PubMed, Scopus, and Cochrane Library. The main topics of data extraction were the changes in systolic and diastolic blood pressure (SBP/DBP), cardiovascular events, treatment adherence, and quality-of-life measures. The risk of bias was assessed using ROB 2.0 and ROBINS-I frameworks.

Results

Out of 99 initially screened studies, six met the inclusion criteria, including two randomized controlled trials (one of which generated two prespecified sub-analyses), one open-label single-arm study, and one crossover trial. The results showed that combining Nebivolol and valsartan decreased SBP and DBP. The highest dose (20/320 mg) achieved a mean SBP reduction of -15.4 mmHg and a DBP reduction of -10.0 mmHg over 8 weeks. Long-term Studies of a 52-week duration showed sustained blood pressure control, with an average drop in SBP of -25.5 mmHg and a drop in DBP of -19.0 mmHg. Additionally, the combination improved heart rate variability and reduced renin-angiotensin-aldosterone system activity. Clinical trials have reported that Nebivolol has a favorable safety profile, with mild and transient symptoms, including fatigue, headache, dyspnea, insomnia, dizziness, and paresthesia, making it a patient-preferred option.

Conclusion

This systematic review provides evidence for the safety and efficacy of the nebivolol-valsartan combination as an antihypertensive regimen. The combination is also beneficial in terms of hemodynamic parameters and overall cardiac load. Nevertheless, large-scale, long-term trials are needed to confirm these results and to define who can benefit most from this therapy.