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 .
A prospective, randomized, open-label, active-controlled, clinical trial to assess central haemodynamic effects of bisoprolol and atenolol in hypertensive patients
Objective : The results from the ASCOT CAFÉ study demonstrated the inferiority of beta blockers in reducing central aortic blood pressure . In this study , we wanted to demonstrate whether or not second-generation beta blockers with higher beta 1 selectivity , namely bisoprolol , may counterbalance the effect of bradycardia through reduced reflection wave magnitude result ing from the relative lack of increase in peripheral vascular resistance . Method : This was a prospect i ve , r and omized , open-label , active-controlled trial in 209 hypertensive patients to evaluate the effect of bisoprolol and atenolol on aortic pulse pressure . Patients received a once-daily 5 mg dose of bisoprolol ( n = 96 ) or 50 mg dose of atenolol ( n = 95 ) at baseline with titration up to bisprolol 10 mg and atenolol 100 mg allowed at the 4th week when the brachial blood pressure was above treatment goal ( average dose : bisoprolol : 5.4 mg , atenolol : 52.8 mg ) . Central blood pressure and augmentation index were measured at baseline and 12 weeks later , by pulse wave analysis with radial artery tonometry . The primary endpoint of the study was the difference in the central pulse pressure ( CPP ) at 12 weeks . Results : The results showed a significant reduction of CPP in both groups at week 12 of administration compared with the predose level ( P < 0.05 ) ; however , there was no significant difference in terms of CPP change  [ bisoprolol ( baseline CPP 47.49 ± 11.33 , follow-up 43.09 ± 11.67 ) vs. atenolol ( baseline CPP 45.93 ± 11.62 , follow-up 42.23 ± 9.92 ) , P = 0.594 ] . Conclusion : In this study , there was no significant difference between bisoprolol and atenolol in terms of reduction of aortic pulse pressure after 12 weeks of treatment
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 .