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 .
Nifedipine and acebutolol in combination for the treatment of moderate to severe essential hypertension.
In a r and omised , crossover study of patients with moderate to severe essential hypertension , the effects of the calcium entry antagonist nifedipine and the beta-receptor blocking drug acebutolol were studied on their own , and in combination . After 4 weeks of nifedipine tablets 20 mg twice daily ( Adalat , Bayer ) , mean supine blood pressure ( BP ) fell by 20 mmHg and after 4 weeks of acebutolol 200 mg twice a day ( Sectral , May & Baker ) by 11 mmHg . When nifedipine and acebutolol were given in combination in the above doses for 4 weeks , there was a significantly greater fall in BP than with either agent alone , supine mean arterial pressure falling by 27 mmHg . The above BPs were measured 2 h after the last dose of tablets . Measurements 12 h after the last dose showed smaller falls in BP , with a significantly greater fall with combination treatment than with acebutolol alone . The fall in BP 12 h after the last dose of the combination was greater than with nifedipine alone but this difference was not statistically significant . This r and omised , controlled study showed that nifedipine and acebutolol have a marked additive effect on BP which is sustained for at least 12 h after treatment
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 .