In conclusion , NVBBs , but not VBBs , determine a lower reduction in cSBP than in pSBP .
However , the difference in treatment-induced SBP amplification changes between NVBB and VBB is nearly abolished after accounting for differences in heart rate changes
β-Blockers are less effective than other antihypertensive drug classes in reducing central systolic blood pressure ( cSBP ) as compared with peripheral SBP ( pSBP ) .
Whether this effect is less pronounced with vasodilating β-blockers ( VBB ) when compared with nonvasodilating β-blockers ( NVBB ) remains unsettled .
Effects of nebivolol on aortic compliance in patients with diabetes and maximal renin angiotensin system blockade: the EFFORT study.
The beneficial effects of nebivolol on arterial stiffness and endothelial dysfunction are well documented in untreated hypertensive patients and differ from nonvasodilatory β-blockers . This study tests the hypothesis that the addition of nebivolol in predominantly African American patients with type 2 diabetes already receiving maximally tolerated doses of renin-angiotensin system ( RAS ) blockers will further improve large artery compliance . Patients with type 2 diabetes and hypertension on maximal RAS blockade ( n=70 ) were r and omized to nebivolol or metoprolol succinate daily . Doses were titrated until systolic blood pressure ( SBP ) was < 130 mm Hg . Radial artery applanation tonometry and pulse wave velocity ( PWV ) analysis were used to derive central aortic pressures and hemodynamic indices at repeated visits at intervals during a 6-month period . Both metoprolol succinate and nebivolol groups demonstrated reductions in brachial SBP ( -8.2±4.3 mm Hg [ P=.01 ] and -7.8±3.7 [ P=.002 ] , respectively ) and aortic DBP ( -2.4±1.8 [ P=.039 ] and -4.0±2.9 mm Hg [ P=.013 ] , respectively ) . Aortic SBP decreased in the nebivolol group only ( 125.3±8 to 121.6±8.2 , P=.025 ) . There were no between group differences in aortic SBP , DBP , augmentation index , or PWV reduction . A significant increase in hemoglobin A1c was observed only in the metoprolol group . In patients with well-controlled type 2 diabetes and hypertension treated with maximally tolerated RAS blockade , nebivolol does not offer significant reductions in aortic BP over metoprolol succinate but maintains a stable metabolic profile
In conclusion , NVBBs , but not VBBs , determine a lower reduction in cSBP than in pSBP .
However , the difference in treatment-induced SBP amplification changes between NVBB and VBB is nearly abolished after accounting for differences in heart rate changes
β-Blockers are less effective than other antihypertensive drug classes in reducing central systolic blood pressure ( cSBP ) as compared with peripheral SBP ( pSBP ) .
Whether this effect is less pronounced with vasodilating β-blockers ( VBB ) when compared with nonvasodilating β-blockers ( NVBB ) remains unsettled .