title: Effect of ivabradine on central aortic blood pressure in patients with stable coronary artery disease: What do we know?
abstract: Treatment of hypertensive patients with beta-blockers decreases central blood pressure (CBP) less than other antihypertensive drugs, which is believed to account for their lesser cardiovascular protection in this setting. Some authors have suggested that decreasing heart rate (HR) with beta-blockers would increase CBP. In contrast to beta-blockers, the anti-anginal agent ivabradine reduces HR without other hemodynamic effects, and represents an attractive tool for exploring the direct relationship between HR and CBP. Here, we review the available clinical data assessing the effect of selective HR reduction with ivabradine on CBP in patients with stable coronary artery disease (CAD). We collected data from five studies which report either increase, decrease, or neutral effects of ivabradine on CBP. Further studies are needed to clarify the exact role of ivabradine on CBP. However, as supported by its pharmacodynamic effect in patients with stable CAD, available evidence to date suggests that ivabradine does not negatively impact CBP when associated with beta-blocker. HR reduction with both beta-blockers and ivabradine remains well-established treatments for the symptomatic treatment of angina patients.
authors.affiliation: Volgograd Medical University, Cardiology Centre, Volgograd, Russian Federation.
authors.forename: Yuri M
authors.initials: YM
authors.lastname: Lopatin
authors.affiliation: Department of Medical Sciences, IRCCS San Raffaele Pisana, Rome, Italy. Electronic address: cristiana.vitale@gmail.com.
authors.forename: Cristiana
authors.initials: C
authors.lastname: Vitale
mesh_terms: D062186:Arterial Pressure / Q000187:drug effects*; D001552:Benzazepines / Q000494:pharmacology*; D002317:Cardiovascular Agents / Q000494:pharmacology; D003324:Coronary Artery Disease / Q000188:drug therapy / Q000503:physiopathology; D006801:Humans; D000077550:Ivabradine; D016896:Treatment Outcome
chemical_list: D001552:Benzazepines; D002317:Cardiovascular Agents; D000077550:Ivabradine
keywords: Central blood pressure; Coronary artery disease; Heart rate; Ivabradine