Different patterns of peripheral versus central blood pressure in hypertensive patients treated with beta-blockers either with or without vasodilator properties or with angiotensin receptor blockers

• Type: Article in International Scientific Journal
• Date: 2010

Authors

Jorge Polonia (Author) FMUP; Loide Barbosa (Author) Other; Jose Alberto Silva (Author) Other; Susana Bertoquini (Author) Other

Journal

Title: Blood Pressure Monitoring

Vol. 15

Pages: 235-239

ISSN: 1359-5237

Publisher: Wolters Kluwer Health

Indexing

ISI Web of Knowledge - 44 Citations

Scopus - 47 Citations

Scientific classification

FOS: Medical and Health sciences > Clinical medicine

Other information

Authenticus ID: P-003-25M

DOI: 10.1097/mbp.0b013e32833c8a64

Abstract (EN): Background It is unclear whether the assumed inferiority of atenolol to reduce central (aortic) blood pressure (BP) extends to other beta-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 +/- 11/10mmHg) and pulse wave velocity (10 +/- 2 m/s), the atenolol group showed significantly (P < 0.03 analysis of variance) higher central systolic BP (139 +/- 9mmHg) 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 beta-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 beta-blockers may exert more favourable central haemodynamic effects, compared with atenolol, which are more alike, although not completely equal, to those of the ARBs. Blood Press Monit 15: 235-239 (C) 2010 Wolters Kluwer Health vertical bar Lippincott Williams & Wilkins.

Language: English

Type (Professor's evaluation): Scientific

No. of pages: 5