When the blood pressure lowering effect of beta-blockers from this review was compared to that of thiazide diuretics from our previous review ( Chen 2009 ) , second-line beta-blockers reduce systolic BP to the same extent as second-line thiazide diuretics , but reduce diastolic BP to a greater degree .
The different effect on diastolic BP means that beta-blockers have little or no effect on pulse pressure whereas thiazides cause a significant dose-related decrease in pulse pressure .
This difference in the pattern of BP lowering with beta-blockers as compared to thiazides might be the explanation for the fact that beta-blockers appear to be less effective at reducing adverse cardiovascular outcomes than thiazide diuretics , particularly in older individuals
BACKGROUND Beta-blockers are one of the more commonly prescribed classes of anti-hypertensive drugs , both as first-line and second-line .
OBJECTIVES To quantify the effect on systolic blood pressure ( SBP ) , diastolic blood pressure ( DBP ) , heart rate and withdrawals due to adverse effects of beta-blocker therapy when given as a second-line drug in adult patients with primary hypertension .
Antihypertensive Efficacy and Tolerability of a Fixed Combination of Metoprolol and Felodipine in Comparison with the Individual Substances in Monotherapy
Summary : In this double-blind , r and omized , parallel-group study , the aim was to compare the efficacy and tolerability of a new fixed combination of felodipine and metoprolol with the individual components in monotherapy . After a placebo period of 4 weeks , 159 patients with mild to moderate essential hypertension were r and omized to extended-release formulations of either felodipine plus metoprolol 10 + 100 mg ( FM ) , felodipine 10 mg ( F ) , or metoprolol 100 mg ( M ) once daily if supine diastolic blood pressure > 95 mm Hg . After 12 weeks of active treatment , the reductions in supine blood pressure ( 24 h after dosing ) were 20/14 , 13/10 , and 11/8 mm Hg for FM , F , and M , respectively . The difference in change was 7/4 mm Hg ( p = 0.004/p = 0.006 ) and 8/5 mm Hg ( p = 0.0002/p < 0.0001 ) for the fixed combination and F or M , respectively . Blood pressure control ( diastolic blood pressure < 90 mm Hg after 12 weeks ) was significantly better for the combination than for F and M , i.e. , 71 % , 49 % ( p = 0.008 ) , and 34 % ( p = 0.004 ) , respectively . Adverse experiences were those to be expected from previous studies with felodipine and metoprolol and did not differ in frequency between groups . It can be concluded that a fixed combination of metoprolol and felodipine has a clinical ly relevant and significantly better blood pressure reduction 24 h postdose than the individual substances in monotherapy , without decreased tolerability
When the blood pressure lowering effect of beta-blockers from this review was compared to that of thiazide diuretics from our previous review ( Chen 2009 ) , second-line beta-blockers reduce systolic BP to the same extent as second-line thiazide diuretics , but reduce diastolic BP to a greater degree .
The different effect on diastolic BP means that beta-blockers have little or no effect on pulse pressure whereas thiazides cause a significant dose-related decrease in pulse pressure .
This difference in the pattern of BP lowering with beta-blockers as compared to thiazides might be the explanation for the fact that beta-blockers appear to be less effective at reducing adverse cardiovascular outcomes than thiazide diuretics , particularly in older individuals
BACKGROUND Beta-blockers are one of the more commonly prescribed classes of anti-hypertensive drugs , both as first-line and second-line .
OBJECTIVES To quantify the effect on systolic blood pressure ( SBP ) , diastolic blood pressure ( DBP ) , heart rate and withdrawals due to adverse effects of beta-blocker therapy when given as a second-line drug in adult patients with primary hypertension .