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 .
Comparative effectiveness of a fixed-dose combination of losartan + HCTZ versus bisoprolol + HCTZ in patients with moderate-to-severe hypertension: results of the 6-month ELIZA trial
Background The aim of this study was to compare the antihypertensive efficacy of losartan 100 mg + hydrochlorothiazide ( HCTZ ) 25 mg versus bisoprolol 10 mg + HCTZ 25 mg and their influence on arterial stiffness and central blood pressure ( BP ) . Methods Of 60 patients with a mean BP of 173.3 ± 1.7/98.4 ± 1.2 mmHg , 59 were r and om-ized to losartan + HCTZ ( n = 32 ) or bisoprolol + HCTZ ( n = 27 ) .  Amlodipine was added if target BP was not achieved at 1 month , and doxazosin was added if target BP was not achieved after 3 months . Body mass index , office and 24-hour ambulatory BP , pulse wave velocity ( carotid-femoral [ PWVE ] and radial [ PWVM ] ) , noninvasive central systolic BP , augmentation index ( AIx ) , laboratory investigations , and electrocardiography were done at baseline and after 6 months of treatment . Results Losartan + HCTZ was as effective as bisoprolol + HCTZ , with target office BP achieved in 96.9 % and 92.6 % of patients and target 24-hour BP in 75 % and 66.7 % of patients , respectively , after 6 months . Effective treatment of BP led to significant lowering of central systolic BP , but this was decreased to a significantly ( P < 0.05 ) greater extent by losartan + HCTZ ( −23.0 ± 2.3 mmHg ) than by bisoprolol + HCTZ ( −15.4 ± 2.9 mmHg ) despite equal lowering of brachial BP . Factors correlated with central systolic BP and its lowering differed between the treatment groups . Losartan + HCTZ did not alter arterial stiffness patterns significantly , but bisoprolol + HCTZ significantly increased AIx . We noted differences in ΔPWVE , ΔPWVM , and ΔAIx between the groups in favor of losartan + HCTZ . Decreased heart rate was associated with higher central systolic BP and AIx in the bisoprolol + HCTZ group , but was not associated with increased AIx in the losartan + HCTZ group . Conclusion Although both treatments decreased both office and 24-hour BP  , losartan + HCTZ  significantly decreased central systolic BP and had a more positive influence on pulse wave velocity , with a less negative effect of decreased heart rate on AIx and central systolic BP
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 .