When the blood pressure lowering effect of beta-blockers from this review was compared to that of thiazide diuretics from our previous review ( Chen 2009 ) , second-line beta-blockers reduce systolic BP to the same extent as second-line thiazide diuretics , but reduce diastolic BP to a greater degree .
The different effect on diastolic BP means that beta-blockers have little or no effect on pulse pressure whereas thiazides cause a significant dose-related decrease in pulse pressure .
This difference in the pattern of BP lowering with beta-blockers as compared to thiazides might be the explanation for the fact that beta-blockers appear to be less effective at reducing adverse cardiovascular outcomes than thiazide diuretics , particularly in older individuals
BACKGROUND Beta-blockers are one of the more commonly prescribed classes of anti-hypertensive drugs , both as first-line and second-line .
OBJECTIVES To quantify the effect on systolic blood pressure ( SBP ) , diastolic blood pressure ( DBP ) , heart rate and withdrawals due to adverse effects of beta-blocker therapy when given as a second-line drug in adult patients with primary hypertension .
Indapamide and atenolol in the treatment of hypertension: double-blind comparative and combination study.
Fifteen out- patients with moderate hypertension were r and omly and sequentially treated with atenolol , indapamide and a combination of the two drugs after a wash-out period of at least 1 week and a 2-week placebo run-in period . The duration of treatment was 4 weeks in each case . The dosage was 2.5 mg indapamide and 100 mg atenolol , in single tablets which were taken at 11.00 hours . All the treatment regimens produced a highly significant ( p less than 0.001 ) reduction in systolic and diastolic , supine and st and ing blood pressure ; these reductions were not significantly different for the single drugs but were significantly greater for the combined therapy . The number of patients reaching the end-point of a diastolic blood pressure of 95 mmHg or less was the same with either atenolol or indapamide , i.e. 7 ( 46.6 % ) , but was greater with the combined therapy , i.e. 10 ( 66.6 % ) . A significant ( p less than 0.001 ) reduction in pulse rate was observed with the treatments involving atenolol .  Acceptability of the treatments was very good ; the number of volunteered and elicited complaints during the different treatments being less compared to the placebo period , particularly for the combined treatment . No significant difference was observed in the blood biochemistry tests . The results are discussed in light of the mechanisms of action of the two drugs , which seem well integrated with each other , and the duration of the antihypertensive effect , which allows a single administration with consequent good treatment compliance
When the blood pressure lowering effect of beta-blockers from this review was compared to that of thiazide diuretics from our previous review ( Chen 2009 ) , second-line beta-blockers reduce systolic BP to the same extent as second-line thiazide diuretics , but reduce diastolic BP to a greater degree .
The different effect on diastolic BP means that beta-blockers have little or no effect on pulse pressure whereas thiazides cause a significant dose-related decrease in pulse pressure .
This difference in the pattern of BP lowering with beta-blockers as compared to thiazides might be the explanation for the fact that beta-blockers appear to be less effective at reducing adverse cardiovascular outcomes than thiazide diuretics , particularly in older individuals
BACKGROUND Beta-blockers are one of the more commonly prescribed classes of anti-hypertensive drugs , both as first-line and second-line .
OBJECTIVES To quantify the effect on systolic blood pressure ( SBP ) , diastolic blood pressure ( DBP ) , heart rate and withdrawals due to adverse effects of beta-blocker therapy when given as a second-line drug in adult patients with primary hypertension .