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 .
Selective reduction of cardiac mass and central blood pressure on low-dose combination perindopril/indapamide in hypertensive subjects
Objective In hypertension , blockade of the renin – angiotensin system reduces left ventricular mass ( LVM ) independently of brachial systolic ( S ) , diastolic ( D ) , and mean ( M ) blood pressure ( BP ) . From central to peripheral arteries , MBP and DBP are practically unchanged , whereas SBP and pulse pressure ( PP ) increase significantly . The objective was to determine whether changes in LVM under drug treatment was preferentially associated with changes in central or brachial SBP and PP . Design A sub study of 146 subjects was selected from 469 hypertensive patients su bmi tted to a double-blind r and omized trial comparing the combination of perindopril ( 2 mg ; Per ) and indapamide ( 0.625 mg ; Ind ) with atenolol ( 50 mg , one tablet per day ) . Main outcome measures Before and after 1 year of treatment : LVM ( echocardiography ) in 146 subjects and , in 52 of them , central ( carotid ) BP and timing of wave reflections ( tonometry ) . Results LVM changes were significantly associated with antihypertensive treatment , with lower LVM with Per/Ind than with atenolol .  Changes in SBP and PP , but not in MBP and DBP , were more significantly associated with Per/Ind than with atenolol , with more pronounced effects using central than brachial measurements , and a longer delay in central return of wave reflections under Per/Ind . In the sampling of 52 patients with tonometry , the change in LVM between the two drug regimens was significantly linked to central , but not brachial , PP change . Conclusions This observational study shows a lower LVM under Per/Ind than under atenolol . The greater change in LVM on Per/Ind was linked to central and not brachial blood pressure
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 .