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 .
The effect of low-dose carvedilol, nebivolol, and metoprolol on central arterial pressure and its determinants: a randomized clinical trial.
In this prospect i ve , open-label , r and omized , controlled clinical trial the effects of low-dose carvedilol , nebivolol , and metoprolol on central arterial pressure and augmentation index ( AIx ) and its heart rate-corrected value ( AIx@75 ) were assessed . The authors r and omized 75 hypertensive patients ( 18 - 70 years ) to carvedilol 12.5/25 mg , metoprolol 50/100 mg , or nebivolol 2.5/5 mg daily and followed them up for 3 months .  Central arterial pressure and AIx were measured with applanation  tonometry  at baseline and at the end of follow-up . Analyses were restricted to 60 completers . Central systolic pressure decreased equally in all 3 treatment arms . AIx remained unchanged , while AIx@75 decreased significantly by 5.4%±2.5 % in the nebivolol group . According to general linear models , individual change in heart rate was a strong predictor of change in AIx in the carvedilol group ( r(2 ) = 0.23 , P=.03 ) although no similar association was found in the nebivolol group ( r(2 ) = 0.09 ) . The impact of β-blockers with vasodilator effects on pressure augmentation seems to be different with nebivolol having the largest potential of decreasing AIx@75 . While AIx changes associated with carvedilol treatment are strongly driven by heart rate changes , those associated with nebivolol treatment seem to be the result of other mechanisms
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 .