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 .
A comparison of atenolol and nebivolol in isolated systolic hypertension
Objectives Some β-blockers are less effective in reducing central blood pressure than other antihypertensive drugs , which may explain the higher rate of events in subjects r and omized to atenolol in recent trials . We hypothesized that nebivolol , a mixed β-blocker/nitro-vasodilator , would be more effective than atenolol in reducing central blood pressure and augmentation index ( AIx ) . The aim of the present study was to test this in a double-blind , r and omized , cross-over study , in a cohort of subjects with isolated systolic hypertension . Methods Following a 2-week placebo run-in , 16 never-treated hypertensive subjects received atenolol ( 50 mg ) , nebivolol ( 5 mg ) and placebo , each for 5 weeks , in a r and om order . Seated brachial blood pressure and heart rate were measured . Aortic blood pressure , AIx and pulse wave velocity ( PWV ) were assessed non-invasively . Results The placebo-corrected fall in brachial pressure was similar between nebivolol and atenolol , as was the reduction in PWV ( mean change ± SEM : −1.0 ± 0.3 and −1.2 ± 0.2 m/s ; P = 0.2 ) . However , there was less reduction in heart rate ( −19 ± 2 versus −23 ± 2 beats/min ; P < 0.01 ) and increase in AIx ( + 6 ± 1 versus + 10 ± 1 % ; P = 0.04 ) , following nebivolol . Aortic pulse pressure was significantly lower ( 50 ± 2 versus 54 ± 2 mmHg ; P = 0.02 ) after nebivolol . N-terminal pro-B-type natriuretic peptide ( proBNP ) rose on both drugs ( 100 ± 33 versus 75 ± 80 pg/ml ; P < 0.01 for both , NS for comparison ) . Conclusions Nebivolol and atenolol have similar effects on brachial blood pressure and aortic stiffness . However , nebivolol reduces aortic pulse pressure more than atenolol , which may be related to a less pronounced rise in AIx and bradycardia . Whether this will translate into differences in clinical outcome requires further investigation
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 .