title: Haemodynamic Influences of Bisoprolol in Hypertensive Middle-Aged Men: A Double-Blind, Randomized, Placebo-Controlled Cross-Over Study.
abstract: Treatment with beta-blockers appears to show inferior reduction in central versus peripheral blood pressure. We aimed to examine simultaneous changes in central and peripheral blood pressure, vascular resistance, cardiac function and arterial stiffness during beta-blockade. Haemodynamics were investigated after 3 weeks of bisoprolol treatment (5 mg/day) in a double-blind, randomized, placebo-controlled cross-over trial in never-treated 16 Caucasian males with grade I-II primary hypertension using continuous tonometric pulse wave analysis and whole-body impedance cardiography. Bisoprolol decreased radial (134/80 versus 144/89 mmHg) and aortic blood pressure (122/80 versus 130/90 mmHg) and heart rate (57 versus 68 beats/min) when compared with placebo (p < 0.05 for all). Ejection duration (336 versus 316 ms) and stroke volume (109 versus 98 ml) were increased (p < 0.01 for all), while cardiac output was not significantly changed (6.2 versus 6.6 l/min). Bisoprolol decreased pulse wave velocity (7.8 versus 8.9 m/s, p < 0.001), but after adjustment for blood pressure, the decrease was not significant (8.16 versus 8.52 m/s, p = 0.464). The treatment reduced pulse pressure amplification from central to peripheral circulation (30 versus 38%, p = 0.002). No differences were observed in systemic vascular resistance, augmentation index, aortic characteristic impedance or total arterial stiffness after bisoprolol versus placebo. Bisoprolol decreased central and peripheral blood pressure and pulse wave velocity in male individuals with grade I to grade II hypertension. The decrease in pulse wave velocity was related to the antihypertensive effect. Reduced pulse pressure amplification indicates that peripheral blood pressure was reduced more efficiently than central blood pressure.
authors.affiliation: School of Medicine, University of Tampere, Tampere, Finland.
authors.forename: Lauri
authors.initials: L
authors.lastname: Suojanen
authors.affiliation: School of Medicine, University of Tampere, Tampere, Finland.
authors.forename: Antti
authors.initials: A
authors.lastname: Haring
authors.affiliation: School of Medicine, University of Tampere, Tampere, Finland.
authors.forename: Antti
authors.initials: A
authors.lastname: Tikkakoski
authors.affiliation: School of Medicine, University of Tampere, Tampere, Finland.
authors.forename: Jenni K
authors.initials: JK
authors.lastname: Koskela
authors.affiliation: School of Medicine, University of Tampere, Tampere, Finland.
authors.forename: Anna M
authors.initials: AM
authors.lastname: Tahvanainen
authors.affiliation: School of Health Sciences, University of Tampere, Tampere, Finland.
authors.forename: Heini
authors.initials: H
authors.lastname: Huhtala
authors.affiliation: School of Medicine, University of Tampere, Tampere, Finland.|Department of Clinical Physiology, Tampere University Hospital, Tampere, Finland.
authors.forename: Mika
authors.initials: M
authors.lastname: Kähönen
authors.affiliation: Department of Clinical Physiology, Tampere University Hospital, Tampere, Finland.
authors.forename: Kalle
authors.initials: K
authors.lastname: Sipilä
authors.affiliation: School of Medicine, University of Tampere, Tampere, Finland.
authors.forename: Arttu
authors.initials: A
authors.lastname: Eräranta
authors.affiliation: School of Medicine, University of Tampere, Tampere, Finland.|Department of Internal Medicine, Tampere University Hospital, Tampere, Finland.
authors.forename: Jukka T
authors.initials: JT
authors.lastname: Mustonen
authors.affiliation: School of Medicine, University of Tampere, Tampere, Finland.
authors.forename: Kari
authors.initials: K
authors.lastname: Kivistö
authors.affiliation: School of Medicine, University of Tampere, Tampere, Finland.|Department of Internal Medicine, Tampere University Hospital, Tampere, Finland.
authors.forename: Ilkka H
authors.initials: IH
authors.lastname: Pörsti
mesh_terms: D058671:Adrenergic beta-1 Receptor Antagonists / Q000009:adverse effects / Q000627:therapeutic use*; D000328:Adult; D000959:Antihypertensive Agents / Q000009:adverse effects / Q000627:therapeutic use*; D017298:Bisoprolol / Q000009:adverse effects / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects; D002302:Cardiac Output / Q000187:drug effects; D002307:Cardiography, Impedance; D018592:Cross-Over Studies; D004311:Double-Blind Method; D000075222:Essential Hypertension / Q000188:drug therapy* / Q000503:physiopathology; D006321:Heart / Q000187:drug effects* / Q000503:physiopathology; D006439:Hemodynamics / Q000187:drug effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D063177:Pulse Wave Analysis; D012720:Severity of Illness Index; D013318:Stroke Volume / Q000187:drug effects; D014655:Vascular Resistance / Q000187:drug effects; D059289:Vascular Stiffness / Q000187:drug effects
chemical_list: D058671:Adrenergic beta-1 Receptor Antagonists; D000959:Antihypertensive Agents; D017298:Bisoprolol