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 .
Improvement in Blood Pressure, Arterial Stiffness and Wave Reflections With a Very-Low-Dose Perindopril/Indapamide Combination in Hypertensive Patient: A Comparison With Atenolol
International guidelines recommend that antihypertensive drug therapy should normalize not only diastolic ( DBP ) but also systolic blood pressure ( SBP ) . Therapeutic trials based on cardiovascular mortality have recently shown that SBP reduction requires normalization of both large artery stiffness and wave reflections . The aim of the present study was to compare the antihypertensive effects of the very-low-dose combination indapamide ( 0.625 mg ) and perindopril ( 2 mg ) ( Per/Ind ) with the & bgr;-blocking agent atenolol ( 50 mg ) to determine whether Per/Ind decreases SBP and pulse pressure ( PP ) more than does atenolol and , if so , whether this decrease is predominantly due to reduction of aortic pulse wave velocity ( PWV ) ( automatic measurements ) and reduction of wave reflections ( pulse wave analysis , applanation tonometry ) . In a double-blind r and omized study , 471 patients with essential hypertension were followed for 12 months . For the same DBP reduction , Per/Ind decreased brachial SBP ( −6.02 mm Hg ; 95 % confidence interval , −8.90 to −3.14 ) and PP ( −5.57 ; 95 % confidence interval , −7.70 to −3.44 ) significantly more than did atenolol . This difference was significantly more pronounced for the carotid artery than for the brachial artery . Whereas the 2 antihypertensive agents decreased PWV to a similar degree , only Per/Ind significantly attenuated carotid wave reflections , result ing in a selective decrease in SBP and PP . The very-low-dose combination Per/Ind normalizes SBP , PP , and arterial function to a significantly larger extent than does atenolol , a hemodynamic profile that is known to improve survival in hypertensive population s with high cardiovascular risk
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 .