title: Comparison of atenolol versus bisoprolol with noninvasive hemodynamic and pulse wave assessment.
abstract: We aimed to compare atenolol versus bisoprolol regarding general hemodynamics, central-peripheral blood pressure (BP), pulse wave parameters, and arterial stiffness. In this open-label, crossover study, we recruited 19 hypertensives, untreated or with stable monotherapy. Patients were randomized to receive atenolol (25-50 mg) or bisoprolol (2.5-5 mg), and then switched medications after 4 weeks. Studies were performed at baseline and after each drug period. In pulse wave analyses, both drugs significantly increased augmentation index (P < .01) and ejection duration (P < .02), and reduced heart rate (P < .001), brachial systolic BP (P ≤ .01), brachial diastolic BP (P ≤ .001), and central diastolic BP (P ≤ .001), but not central systolic BP (P ≥ .06). Impedance cardiographic assessment showed a significantly increased stroke volume (P ≤ .02). There were no significant differences in the effects between drugs. In conclusion, atenolol and bisoprolol show similar hemodynamic characteristics. Failure to decrease central systolic BP results from bradycardia with increased stroke volume and an earlier reflected aortic wave.
authors: Hypertension Section, Internal Medicine Department, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina. Electronic address: lucas.aparicio@hospitalitaliano.org.ar.
authors: Lucas S
authors: LS
authors: Aparicio
authors: Hypertension Section, Internal Medicine Department, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
authors: José
authors: J
authors: Alfie
authors: Hypertension Section, Internal Medicine Department, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
authors: Jessica
authors: J
authors: Barochiner
authors: Hypertension Section, Internal Medicine Department, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
authors: Paula E
authors: PE
authors: Cuffaro
authors: Internal Medicine Research Unit, Internal Medicine Department, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
authors: Diego H
authors: DH
authors: Giunta
authors: Internal Medicine Research Unit, Internal Medicine Department, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
authors: Cristina M
authors: CM
authors: Elizondo
authors: Family Medicine Department, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
authors: Juan J
authors: JJ
authors: Tortella
authors: Hypertension Section, Internal Medicine Department, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
authors: Margarita S
authors: MS
authors: Morales
authors: Hypertension Section, Internal Medicine Department, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
authors: Marcelo A
authors: MA
authors: Rada
authors: Hypertension Section, Internal Medicine Department, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
authors: Gabriel D
authors: GD
authors: Waisman
mesh_terms: D000886:Anthropometry; D000959:Antihypertensive Agents / Q000494:pharmacology* / Q000627:therapeutic use; D001262:Atenolol / Q000494:pharmacology* / Q000627:therapeutic use; D015415:Biomarkers / Q000097:blood; D017298:Bisoprolol / Q000627:therapeutic use*; D002307:Cardiography, Impedance; D018592:Cross-Over Studies; D005260:Female; D006439:Hemodynamics / Q000187:drug effects* / Q000502:physiology; D006801:Humans; D006973:Hypertension / Q000188:drug therapy / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D063177:Pulse Wave Analysis; D012307:Risk Factors; D014655:Vascular Resistance / Q000187:drug effects / Q000502:physiology; D059289:Vascular Stiffness / Q000187:drug effects / Q000502:physiology
chemical_list: D000959:Antihypertensive Agents; D015415:Biomarkers; D001262:Atenolol; D017298:Bisoprolol
keywords: Beta-blocker; central blood pressure; hypertension; impedance cardiography