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 .
Aortic Pressure Augmentation Predicts Adverse Cardiovascular Events in Patients With Established Coronary Artery Disease
Pulse pressure ( PP ) , a marker of arterial stiffness , predicts cardiovascular risk . We aim ed to determine whether augmentation pressure ( AP ) derived from the aortic pressure waveform predicts major adverse cardiovascular events ( MACE ) and death independently of PP in patients with established coronary artery disease ( CAD ) . We prospect ively followed-up 297 males undergoing coronary angiography for 1186±424 days .  Ascending aortic pressure tracings obtained during catheterization were used to calculate AP ( difference between the second and the first systolic peak ) .  Augmentation index  ( AIx ) was defined as AP as a percentage of PP . We evaluated whether AP and AIx can predict the risk of MACE ( unstable angina , acute myocardial infa rct ion , coronary revascularization , stroke , or death ) and death using Cox regression . All models evaluating AP included PP to assess whether AP adds to the information already provided by PP . Both AP and AIx significantly predicted MACE . The hazard ratio ( HR ) per 10 mm Hg increase in AP was 1.20 ( 95 % confidence interval [ CI ] , 1.08 to 1.34 ; P<0.001 ) ; the HR for each 10 % increase in AIx was 1.28 ( 95 % CI , 1.11 to 1.48 ; P=0.004 ) . After adjusting for other univariate predictors of MACE , age , and other potential confounders , AP remained a significant predictor of MACE ( HR per 10 mm Hg increase=1.19 ; 95 % CI , 1.06 to 1.34 ; P=0.002 ) , as did AIx ( adjusted HR , 1.28 ; 95 % CI , 1.09 to 1.50 ; P=0.003 ) . AP was a significant predictor of death ( HR per 10 mm Hg increase=1.18 ; 95 % CI , 1.02 to 1.39 ; P=0.03 ) . Higher AIx was associated with a trend toward increased mortality ( HR=1.22 ; 95 % CI , 0.98 to 1.52 ; P=0.056 ) . Aortic AP predicts adverse outcomes in patients with CAD independently of PP and other risk markers
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 .