SBP-lowering effects were significantly increased for bisoprolol compared with placebo .
In conclusion , current evidence does not support carvedilol or bisoprolol as first-line therapy for adult hypertension without compelling indications
Although beta blockers have been used as initial therapy for ischemic heart diseases and heart failure , the beneficial effects of beta blockers are controversial compared with other antihypertensive agents as initial therapy for hypertension without compelling indications .
Moreover , atenolol has been most commonly used with beta blockers .
The objective of the present systematic review associated with the Japanese Society of Hypertension ( JSH ) 2019 Hypertension Guideline ( Clinical Question 6 ) was to assess the outcomes ( cardiocerebrovascular mortality , total cause mortality , hypotension , bradycardia , other adverse effects , and changes in systolic blood pressure ( SBP ) ) of currently used carvedilol and bisoprolol as initial therapy for adult hypertension without compelling indications .
Effect of bisoprolol on blood pressure and arterial hemodynamics in systemic hypertension.
Blood pressure , heart rate , common carotid and brachial arterial hemodynamics using pulsed Doppler flowmetry and pulse wave velocity determinations were evaluated using a double-blind crossover design versus placebo in 14 patients with sustained essential hypertension treated by the selective beta 1 blocking agent bisoprolol .  Blood pressure and heart rate significantly decreased after bisoprolol , whereas no significant change occurred in the diameter , the blood flow and in the vascular resistance of the carotid and brachial circulations . Pulse wave velocity significantly decreased in the brachioradial and the carotid femoral areas . The decrease in the latter was -1.6 + /- 0.8 m/s with bisoprolol and -0.06 + /- 0.80 m/s with placebo ( p = 0.001 ) . Brachial artery compliance significantly increased from 117 + /- 49 to 205 + /- 84 cm4 x dynes-1 x 10(9 ) ( p = 0.001 ) , indicating that the antihypertensive effect of beta 1 blockade is associated with an improvement in the viscoelastic properties of the brachial artery wall
SBP-lowering effects were significantly increased for bisoprolol compared with placebo .
In conclusion , current evidence does not support carvedilol or bisoprolol as first-line therapy for adult hypertension without compelling indications
Although beta blockers have been used as initial therapy for ischemic heart diseases and heart failure , the beneficial effects of beta blockers are controversial compared with other antihypertensive agents as initial therapy for hypertension without compelling indications .
Moreover , atenolol has been most commonly used with beta blockers .
The objective of the present systematic review associated with the Japanese Society of Hypertension ( JSH ) 2019 Hypertension Guideline ( Clinical Question 6 ) was to assess the outcomes ( cardiocerebrovascular mortality , total cause mortality , hypotension , bradycardia , other adverse effects , and changes in systolic blood pressure ( SBP ) ) of currently used carvedilol and bisoprolol as initial therapy for adult hypertension without compelling indications .