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 Randomized Controlled Study on the Effects of Bisoprolol and Atenolol on Sympathetic Nervous Activity and Central Aortic Pressure in Patients with Essential Hypertension
Objective β-blockers ( BBs ) with different pharmacological properties may have heterogeneous effects on sympathetic nervous activity ( SNA ) and central aortic pressure ( CAP ) , which are independent cardiovascular factors for hypertension . Hence , we analyzed the effects of bisoprolol and atenolol on SNA and CAP in hypertensive patients . Methods This was a prospect i ve , r and omized , controlled study in 109 never-treated hypertensive subjects r and omized to bisoprolol ( 5 mg ) or atenolol ( 50 mg ) for 4–8 weeks .  SNA , baroreflex sensitivity ( BRS ) and heart rate ( HR ) variability ( HRV ) were measured using power spectral analysis using a Finometer . CAP and related parameters were determined using the SphygmoCor device ( pulse wave analysis ) . Results Both drugs were similarly effective in reducing brachial BP . However , central systolic BP ( −14±10 mm Hg vs −6±9 mm Hg ; P<0.001 ) and aortic pulse pressure ( −3±10 mm Hg vs + 3±8 mm Hg ; P<0.001 ) decreased more significantly with bisoprolol than with atenolol .  The augmentation index at a HR of 75 bpm ( AIxatHR75 ) was significantly decreased ( 29%±11 % to 25%±12 % ; P = 0.026 ) in the bisoprolol group only . Furthermore , the change in BRS in the bisoprolol group ( 3.99±4.19 ms/mmHg ) was higher than in the atenolol group ( 2.66±3.78 ms/mmHg ) , although not statistically significant ( P>0.05 ) . BRS was stable when RHR was controlled ( RHR≤65 bpm ) , and the two treatments had similar effects on the low frequency/high frequency ( HF ) ratio and on HF . Conclusion BBs seem to have different effects on arterial distensibility and compliance in hypertensive subjects . Compared with atenolol , bisoprolol may have a better effect on CAP . Trial Registration Clinical Trials.gov
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 .