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 .
Different effects of fosinopril and atenolol on wave reflections in hypertensive patients.
We conducted this study to compare the effects of fosinopril versus atenolol on peripheral blood pressure , central arterial wave reflection , and left ventricular mass in a group of patients with essential hypertension . We conducted a double-blind , r and omized trial of fosinopril and atenolol in 79 hypertensive patients ( 52 men , 27 women ; mean age , 45.8 + /- 8.5 years ; range , 30 to 68 years ) .  Carotid pressure waveforms were recorded noninvasively by applanation tonometry with a Millar micromanometer-tipped probe . The extent of wave reflection was estimated by the augmentation index defined as the ratio of the amplitude of pressure wave above its systolic shoulder to the pulse pressure . The augmentation index , left ventricular mass index by two-dimensional echocardiography , and 24-hour ambulatory blood pressures were determined before and after 8 weeks of daily treatment with fosinopril ( 10 to 20 mg ) or atenolol ( 50 to 100 mg ) with or without diuretics and compared with those values in 79 normotensive control subjects . After 8 weeks of treatment , both drugs lowered 24-hour ambulatory peripheral systolic and diastolic pressures into the normal range to a similar extent ( fosinopril , -18/-13 mm Hg ; atenolol , -23/-17 mm Hg , both P = NS ) . On the other h and , whereas the elevated augmentation index in hypertensive patients compared with normotensive subjects ( 16 + /- 11 % versus 10 + /- 8 % ) was completely normalized by fosinopril ( -9.3 + /- 9.8 % , P < or = .002 ) , it was lowered by atenolol ( -4.8 + /- 8.9 % , P < .002 ) but to a significantly smaller extent ( fosinopril versus atenolol effect , P = .04 ) . ( ABSTRACT TRUNCATED AT 250 WORDS
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 .