title: A randomized controlled study on the effects of bisoprolol and atenolol on sympathetic nervous activity and central aortic pressure in patients with essential hypertension.
abstract: OBJECTIVE
  β-blockers (BBs) with different pharmacological properties may have heterogeneous effects on sympathetic nervous activity (SNA) and central aortic pressure (CAP), which are independent cardiovascular factors for hypertension. Hence, we analyzed the effects of bisoprolol and atenolol on SNA and CAP in hypertensive patients.
  
  
  METHODS
  This was a prospective, randomized, controlled study in 109 never-treated hypertensive subjects randomized to bisoprolol (5 mg) or atenolol (50 mg) for 4-8 weeks. SNA, baroreflex sensitivity (BRS) and heart rate (HR) variability (HRV) were measured using power spectral analysis using a Finometer. CAP and related parameters were determined using the SphygmoCor device (pulse wave analysis).
  
  
  RESULTS
  Both drugs were similarly effective in reducing brachial BP. However, central systolic BP (-14±10 mm Hg vs -6±9 mm Hg; P<0.001) and aortic pulse pressure (-3±10 mm Hg vs +3±8 mm Hg; P<0.001) decreased more significantly with bisoprolol than with atenolol. The augmentation index at a HR of 75 bpm (AIxatHR75) was significantly decreased (29%±11% to 25%±12%; P = 0.026) in the bisoprolol group only. Furthermore, the change in BRS in the bisoprolol group (3.99±4.19 ms/mmHg) was higher than in the atenolol group (2.66±3.78 ms/mmHg), although not statistically significant (P>0.05). BRS was stable when RHR was controlled (RHR≤65 bpm), and the two treatments had similar effects on the low frequency/high frequency (HF) ratio and on HF.
  
  
  CONCLUSIONS
  BBs seem to have different effects on arterial distensibility and compliance in hypertensive subjects. Compared with atenolol, bisoprolol may have a better effect on CAP.
  
  
  BACKGROUND
  ClinicalTrials.gov NCT01762436.
authors.affiliation: State Key Laboratory of Medical Genomics, Shanghai Key Laboratory of Hypertension and Department of Hypertension, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China ; Shanghai Institute of Hypertension, Shanghai, China ; Laboratory of Vascular Biology, Institute of Health Sciences, Shanghai Institutes for Biological Sciences, Chinese Academy of Sciences, Shanghai, China.
authors.forename: Wei-Jun
authors.initials: WJ
authors.lastname: Zhou
authors.forename: Ren-Ying
authors.initials: RY
authors.lastname: Wang
authors.forename: Yan
authors.initials: Y
authors.lastname: Li
authors.forename: Dong-Rui
authors.initials: DR
authors.lastname: Chen
authors.forename: Er-Zhen
authors.initials: EZ
authors.lastname: Chen
authors.forename: Ding-Liang
authors.initials: DL
authors.lastname: Zhu
authors.forename: Ping-Jin
authors.initials: PJ
authors.lastname: Gao
mesh_terms: D000328:Adult; D000959:Antihypertensive Agents / Q000494:pharmacology / Q000627:therapeutic use*; D062186:Arterial Pressure / Q000187:drug effects*; D001262:Atenolol / Q000494:pharmacology / Q000627:therapeutic use*; D017704:Baroreflex / Q000187:drug effects; D017298:Bisoprolol / Q000494:pharmacology / Q000627:therapeutic use*; D000075222:Essential Hypertension; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D016896:Treatment Outcome
chemical_list: D000959:Antihypertensive Agents; D001262:Atenolol; D017298:Bisoprolol
references.citation: Am J Cardiol. 1991 Jul 1;68(1):61-4
references.pmid: 1676238
references.citation: Hypertension. 1996 Feb;27(2):209-18
references.pmid: 8567043
references.citation: Br J Clin Pharmacol. 1998 Mar;45(3):271-6
references.pmid: 9517371
references.citation: J Cardiovasc Pharmacol. 1991 Jul;18(1):28-34
references.pmid: 1719288
references.citation: Int J Cardiol. 2007 Aug 9;120(1):10-27
references.pmid: 17433471
references.citation: Hypertens Res. 2000 Sep;23(5):537-40
references.pmid: 11016810
references.citation: Hypertension. 2001 Oct;38(4):932-7
references.pmid: 11641312
references.citation: J Hypertens. 2006 Nov;24(11):2131-41
references.pmid: 17053529
references.citation: J Hypertens. 2011 Jun;29(6):1034-42
references.pmid: 21519280
references.citation: J Cardiovasc Pharmacol. 1988;12 Suppl 3:S121-9
references.pmid: 2467097
references.citation: Am J Hypertens. 1992 Sep;5(9):624-8
references.pmid: 1358118
references.citation: Circulation. 1997 Apr 1;95(7):1827-36
references.pmid: 9107170
references.citation: Hypertension. 2002 Mar 1;39(3):735-8
references.pmid: 11897754
references.citation: Hypertension. 2007 Jul;50(1):197-203
references.pmid: 17485598
references.citation: J Clin Pharmacol. 1986 Nov-Dec;26(8):616-21
references.pmid: 2878941
references.citation: Circulation. 2006 Mar 7;113(9):1213-25
references.pmid: 16476843
references.citation: J Cardiovasc Pharmacol. 1986;8 Suppl 11:S16-20
references.pmid: 2439789
references.citation: J Hypertens. 1998 Dec;16(12 Pt 2):2079-84
references.pmid: 9886900
references.citation: J Cardiovasc Pharmacol. 2006 Feb;47(2):169-74
references.pmid: 16495752
references.citation: J Hypertens. 1996 Feb;14(2):243-50
references.pmid: 8728303
references.citation: J Cardiovasc Pharmacol. 1994 Jun;23(6):897-906
references.pmid: 7523781
references.citation: J Hum Hypertens. 1999 Mar;13(3):185-90
references.pmid: 10204815
references.citation: Am J Hypertens. 2004 Feb;17(2):129-33
references.pmid: 14751654
references.citation: Br J Clin Pharmacol. 1997 Jul;44(1):61-8
references.pmid: 9241098
references.citation: J Hypertens. 2000 Jan;18(1):7-19
references.pmid: 10678538
references.citation: Am J Hypertens. 2003 Nov;16(11 Pt 1):966-72
references.pmid: 14573336
references.citation: Am J Cardiol. 1987 Feb 1;59(4):256-62
references.pmid: 3812275
references.citation: Circulation. 1996 Mar 1;93(5):1043-65
references.pmid: 8598068
references.citation: Cardiovasc Res. 1997 Mar;33(3):698-705
references.pmid: 9093542
references.citation: Am J Cardiol. 1994 Apr 1;73(9):653-7
references.pmid: 8166060
references.citation: J Hypertens. 2002 Dec;20(12):2407-14
references.pmid: 12473865
references.citation: Lancet. 2002 Mar 23;359(9311):995-1003
references.pmid: 11937178
references.citation: Hypertension. 1987 Mar;9(3):309-14
references.pmid: 3818023
references.citation: Circulation. 1988 Oct;78(4):957-68
references.pmid: 3048776
references.citation: J Hypertens. 2008 Feb;26(2):351-6
references.pmid: 18192850
references.citation: Circulation. 2001 Apr 24;103(16):2072-7
references.pmid: 11319197
references.citation: Arterioscler Thromb Vasc Biol. 2002 Jan;22(1):147-52
references.pmid: 11788475
references.citation: Lancet. 2005 Oct 29-Nov 4;366(9496):1545-53
references.pmid: 16257341
references.citation: Am J Hypertens. 2004 Feb;17(2):118-23
references.pmid: 14751652
references.citation: Lancet. 2004 Nov 6-12;364(9446):1684-9
references.pmid: 15530629
references.citation: Gen Pharmacol. 2000 Oct;35(4):219-24
references.pmid: 11827729
references.citation: Lancet. 2008 Sep 6;372(9641):817-21
references.pmid: 18757091
references.citation: Am J Hypertens. 2004 Mar;17(3):217-22
references.pmid: 15001194
references.citation: Am J Physiol Regul Integr Comp Physiol. 2002 Aug;283(2):R533-42
references.pmid: 12121868
references.citation: J Physiol. 2000 May 15;525 Pt 1:263-70
references.pmid: 10811742
references.citation: J Hypertens. 2004 Jul;22(7):1371-80
references.pmid: 15201554
references.citation: J Am Coll Cardiol. 2007 Aug 28;50(9):823-30
references.pmid: 17719466
references.citation: Circulation. 1996 Oct 15;94(8):1870-5
references.pmid: 8873662
references.citation: Cardiovasc Res. 1998 Jun;38(3):605-16
references.pmid: 9747429