Document Detail

Different patterns of peripheral versus central blood pressure in hypertensive patients treated with β-blockers either with or without vasodilator properties or with angiotensin receptor blockers.
MedLine Citation:
PMID:  20577082     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: It is unclear whether the assumed inferiority of atenolol to reduce central (aortic) blood pressure (BP) extends to other β-blockers with vasodilating properties and, within that scope, how these drugs differ from the angiotensin receptor blockers (ARBs).
METHODS: In a retrospective study, we compared three groups of hypertensive patients (aged 35-65 years) chronically treated with either ARBs (n=83, group 1), carvedilol/nebivolol (n=75, 25+25 mg/day/5 mg/day, group 2) or atenolol (n=84, 50-100 mg/day, group 3), matched for age (mean 52 years), sex (61% female), brachial BP and concomitant use of diuretics (75-81%)and dihydropyridine calcium antagonists (27-33%). We measured aortic stiffness by pulse wave velocity (Complior), and central BP, central-peripheral pulse pressure amplification, wave reflection [augmentation index (AIx) corrected for heart rate] and augmentation pressure (Sphygmocor).
RESULTS: For similar age, sex distribution, brachial BP levels (145/85±11/10 mmHg) and pulse wave velocity (10±2 m/s), the atenolol group showed significantly (P<0.03 analysis of variance) higher central systolic BP (139±9 mmHg) versus group 2 (135±10 mmHg) and group 1 (132±11 mmHg), higher AIx (34±12%) versus group 2 (27±7%) and group 1 (23.0±9%), lower pulse pressure amplification (1.16±0.09) versus group 2 (1.22±0.10) and group 1 (1.31±0.11) and lower heart rate beats/min (61±9) versus group 2 (69±11) and group 1 (82±11). The differences on these values, between group 2 and group 1, were also significant (P<0.04). After adjustment for the heart rate, AIx became similar in groups 2 and 1, but still lower (P<0.04) than the atenolol group.
CONCLUSION: These findings suggest that, for similar brachial BP and aortic stiffness, treatment with either vasodilating β-blockers or angiotensin receptor blockers associates with lower central systolic BP and wave reflections than treatment with atenolol. These findings may suggest that the vasodilating β-blockers may exert more favourable central haemodynamic effects, compared with atenolol, which are more alike, although not completely equal, to those of the ARBs.
Jorge Polónia; Loide Barbosa; José Alberto Silva; Susana Bertoquini
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Blood pressure monitoring     Volume:  15     ISSN:  1473-5725     ISO Abbreviation:  Blood Press Monit     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-09-17     Completed Date:  2011-01-05     Revised Date:  2013-05-28    
Medline Journal Info:
Nlm Unique ID:  9606438     Medline TA:  Blood Press Monit     Country:  England    
Other Details:
Languages:  eng     Pagination:  235-9     Citation Subset:  IM    
Faculdade de Medicina do Porto, Hospital Pedro Hispano, Matosinhos, Porto, Portugal.
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MeSH Terms
Adrenergic beta-Antagonists / therapeutic use*
Angiotensin Receptor Antagonists / therapeutic use*
Antihypertensive Agents / therapeutic use*
Aorta / physiopathology
Atenolol / therapeutic use
Benzopyrans / therapeutic use
Blood Flow Velocity / drug effects
Blood Pressure / drug effects*
Brachial Artery
Calcium Channel Blockers / therapeutic use
Carbazoles / therapeutic use
Dihydropyridines / therapeutic use
Diuretics / therapeutic use
Ethanolamines / therapeutic use
Heart Rate / drug effects
Hypertension / drug therapy
Middle Aged
Propanolamines / therapeutic use
Pulsatile Flow / drug effects
Retrospective Studies
Vascular Resistance / drug effects
Vasodilator Agents / therapeutic use*
Reg. No./Substance:
0/Adrenergic beta-Antagonists; 0/Angiotensin Receptor Antagonists; 0/Antihypertensive Agents; 0/Benzopyrans; 0/Calcium Channel Blockers; 0/Carbazoles; 0/Dihydropyridines; 0/Diuretics; 0/Ethanolamines; 0/Propanolamines; 0/Vasodilator Agents; 030Y90569U/nebivolol; 0K47UL67F2/carvedilol; 29122-68-7/Atenolol

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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