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 .
Beta-blockers reduce aortic stiffness in hypertension but nebivolol, not atenolol, reduces wave reflection.
BACKGROUND There is conflicting information with regard to the effect of beta-blockers on arterial stiffness and wave reflection . We compared a vasodilating beta-blocker , nebivolol , with atenolol . METHODS We r and omized 40 subjects with untreated hypertension ( mean + /- s.e.m . systolic/diastolic blood pressure ( BP ) of 160 + /- 3/98 + /- 1 mm Hg , age 49 + /- 1 years ) 16 of whom were women , to atenolol 50 mg or nebivolol 5 mg daily for 4 weeks .  Arterial stiffness was assessed in terms of carotid-femoral pulse wave velocity ( PWV , Complior ) and arterial wave reflection ( augmentation index ( AIx ) by applanation tonometry , Sphygmocor ) . RESULTS Both beta-blockers produced an equal reduction in brachial BP but aortic pulse pressure ( PP ) was reduced to a greater extent by nebivolol ( P < 0.05 ) . PWV was decreased significantly by both therapies ( nebivolol : from 11.5 + /- 0.5 to 9.9 + /- 0.5 m/s ; atenolol : from 11.1 + /- 0.4 to 9.8 + /- 0.4 m/s ; P < 0.01 ) but only nebivolol significantly reduced AIx ( from 35 + /- 5 to 28 + /- 2 % , P < 0.05 ) . In addition , whereas PP amplification ( PP , mm Hg ) decreased with atenolol therapy ( from 10 + /- 1 to 7 + /- 1 , P < 0.01 ) , it increased with nebivolol therapy ( from 8 + /- 1 to 14 + /- 3 , P < 0.01 ) . Atenolol reduced heart rate to a greater extent than nebivolol did ( 14 + /- 3/min reduction by atenolol vs. 8 + /- 2/min reduction by nebivolol , P < 0.05 ) . There was no difference between the two treatments in respect of the effect on transit time . CONCLUSION The beta-blockers , atenolol and nebivolol , have a similar effect in reducing arterial stiffness in the large elastic aorta , largely secondary to BP reduction . Nebivolol , in contrast to atenolol , has an effect on small muscular arteries , increasing PP amplification and reducing wave reflection , possibly because of increased levels of nitric oxide ( NO ) . Such ancillary properties may impart important distinct hemodynamic effects , and therefore beta-blockers can not be regarded as a homogeneous group
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 .