150.00 rub.
Buy article

Comparative effects of bisoprolol and verapamil on central and peripheral BP in patients with arterial hypertension

Orlova Ia. A.1, Mikhaylov G. V.2, Vitsenya M. V.2
1 – Federal State Budgetary Educational Institution of Higher Education, "M.V. Lomonosov Moscow State University", Leninskie Gory 1, GSP-1, Moscow 119991
2 – Federal State Budgetary Institution, "Russian Cardiology Science and Production Center" of the Ministry of Health of the Russian Federation, 3rd Cherepkovskaya 15a, Moscow 121552

Keywords: central pressure, vascular stiffness, augmentation index, pulse wave velocity, verapamil, bisoprolol

DOI: 10.18087/rhj.2017.1.2277

Background. Emergence of noninvasive methods for measuring central blood pressure along with reports of its essential effect on LV hypertrophy, coronary and kidney perfusion and, therefore, more strict relationship with development of cardiovascular complications allots new tasks of evaluating the efficacy of drug therapy for AH. Aim. To compare effects of bisoprolol and verapamil on peripheral and central blood pressure in patients with AH. Materials and methods. 60 patients (mean age, 55±12; 29 men and 31 women) with grade 1–2 AH and heart rate (HR) higher than 75 bpm were included. Central systolic BP (cSBP), central pulse BP (cPBP), peripheral systolic (SBP) and peripheral pulse BP (PBP), augmentation index (AI%), HR , brachial-ankle pulse wave velocity (baPWV), and carotid-femoral pulse wave velocity (cf PWV) were measured. The measurements were performed at enrollment and after 3 months of bisoprolol or verapamil treatment. Results. Both therapies resulted in decreased SBP, PBP and HR. The bisoprolol treatment decreased cSBP (from 142.7 to 136.6 mm Hg) and cPBP (from 49.7 to 43.3 mm Hg) and increased AI% (from 31.5 to 35.2). The verapamil treatment reduced cSBP (from 135.4 to 126.9 mm Hg) whereas AI% and cPBP remained unchanged. Both drugs reduced stiffness but the effect of bisoprolol was more pronounced.
  1. Williams B, Lacy PS, Thom SM, Cruickshank K, Stanton A, Collier D et al. Differential impact of blood pressure-lowering drugs on central aortic pressure and clinical outcomes: principal results of the Conduit Artery Function Evaluation (CAFE) study. Circulation. 2006 Mar 7;113 (9):1213–25.
  2. Takami T, Saito Y. Effects of Azelnidipine plus OlmesaRTAn versus amlodipine plus olmesartan on central blood pressure and left ventricular mass index: the AORTA study. Vasc Health Risk Manag. 2011;7:383–90.
  3. Roman MJ, Devereux RB, Kizer JR , Lee ET, Galloway JM, Ali T et al. Central pressure more strongly relates to vascular disease and outcome than does brachial pressure: the Strong Heart Study. Hypertension. 2007 Jul;50 (1):197–203.
  4. Wang KL, Cheng HM, Chuang SY, Spurgeon HA, Ting CT, Lakatta EG et al. Central or peripheral systolic or pulse pressure: which best relates to target organs and future mortality? J Hypertens. 2009 Mar;27 (3):461–7.
  5. Pini R , Cavallini MC, Palmieri V, Marchionni N, Di Bari M, Devereux RB et al. Central but not brachial blood pressure predicts cardiovascular events in an unselected geriatric population: the ICARe Dicomano Study. J Am Coll Cardiol. 2008 Jun 24;51 (25):2432–9.
  6. Huang CM, Wang KL, Cheng HM, Chuang SY, Sung SH, Yu WC et al. Central versus ambulatory blood pressure in the prediction of all-cause and cardiovascular mortalities. J Hypertens. 2011 Mar;29 (3):454–9.
  7. Safar ME, Blacher J, Pannier B, Guerin AP, Marchais SJ, Guyonvarc’h PM, London GM. Central pulse pressure and mortality in end-stage renal disease. Hypertension. 2002 Mar 1;39 (3):735–8.
  8. Protogerou AD, Stergiou GS, Vlachopoulos C, Blacher J, Achimastos A. The effect of antihypertensive drugs on central blood pressure beyond peripheral blood pressure. Part II: Evidence for specific class-effects of antihypertensive drugs on pressure amplification. Curr Pharm Des. 2009;15 (3):272–89.
  9. Schneider MP, Delles C, Klingbeil AU, Ludwig M, Kolloch RE, Krekler M et al. Effect of angiotensin receptor blockade on central haemodynamics in essential hypertension: results of a randomised trial. J Renin Angiotensin Aldosterone Syst. 2008 Mar;9 (1):49–56.
  10. Mackenzie IS, McEniery CM, Dhakam Z, Brown MJ, Cockcroft JR, Wilkinson IB. Comparison of the effects of antihypertensive agents on central blood pressure and arterial stiffness in isolated systolic hypertension. Hypertension. 2009 Aug;54 (2):409–13.
  11. Virdis A, Ghiadoni L, Qasem AA, Lorenzini G, Duranti E, Cartoni G et al. Effect of aliskiren treatment on endothelium-dependent vasodilation and aortic stiffness in essential hypertensive patients. Eur Heart J. 2012 Jun;33 (12):1530–8.
  12. Inoue T, Iseki K, Iseki C, Kinjo K, Ohya Y, Takishita S. Higher heart rate predicts the risk of developing hypertension in a normotensive screened cohort. Circ J. 2007 Nov;71 (11):1755–60.
  13. Palatini P, Dorigatti F, Zaetta V, Mormino P, Mazzer A, Bortolazzi A et al. Heart rate as a predictor of development of sustained hypertension in subjects screened for stage 1 hypertension: the HARVEST Study. J Hypertens. 2006 Sep;24 (9):1873–80.
  14. Van Bortel LM, Laurent S, Boutouyrie P, Chowienczyk P, Cruickshank JK, De Backer T et al. Expert consensus document on the measurement of aortic stiffness in daily practice using carotid-femoral pulse wave velocity. J Hypertens. 2012 Mar;30 (3):445–8.
  15. Yamashina A, Tomiyama H, Takeda K, Tsuda H, Arai T, Hirose K et al. Validity, reproducibility and clinical significance brachialankle pulse wave velocity measurement. Hypertens Res. 2002 May;25 (3):359–64.
  16. Chen CH, Nevo E, Fetics B, Pak PH, Yin FC, Maughan WL, Kass DA. Estimation of central aortic pressure waveform by mathematical transformation of radial tonometry pressure: validation of generalized transfer function. Circulation. 1997 Apr 1;95 (7):1827–36.
  17. Kolloch R , Legler UF, Champion A, Cooper-Dehoff RM, Handberg E, Zhou Q, Pepine CJ. Impact of resting heart rate on outcomes in hypertensive patients with coronary artery disease: findings from the INternational VErapamil-SR/trandolapril STudy (INVEST). Eur Heart J. 2008 May; 29 (10):1327–34.
  18. Boden WE, Vray M, Eschwege E, Lauret D, Scheldewaert R . Heart rate-lowering and -regulating effects of once-daily sustained-release diltiazem. Clin Cardiol. 2001 Jan;24 (1):73–9.
  19. Carlberg B, Samuelsson O, Lindholm LH. Atenolol in hypertension: is it a wise choice? Lancet. 2004 Nov 6–12;364 (9446):1684–9.
  20. Dahlof B, Devereux RB, Kjeldsen SE, Julius S, Beevers G, de Faire U et al. Cardiovascular morbidity and mortality in the Losartan Intervention For Endpoint reduction in hypertension study (LIFE): a randomised trial against atenolol. Lancet. 2002 Mar 23;359 (9311): 995–1003.
  21. Lindholm LH, Carlberg B, Samuelsson O. Should β-blockers remain first choice in the treatment of primary hypertension? A meta-analysis. Lancet. 2005 Oct 29-Nov 4;366 (9496):1545–53.
  22. Asmar RG, London GM, O’Rourke ME, Safar ME. Improvement of blood pressure, arterial stiffness and wave reflections with a very low dose Perindopril/Indapamide combination in hypertensive patients: a comparison with Atenolol. Hypertension. 2001 Oct;38 (4):922–6.
  23. McEniery CM, Schmitt M, Qasem A, Webb DJ, Avolio AP, Wilkinson IB, Cockcroft JR. Nebivolol increases arterial distensibility in vivo. Hypertension. 2004 Sep;44 (3):305–10.
  24. Kampus P, Serg M, Kals J, Zagura M, Muda P, Karu K et al. Differential effects of nebivolol and metoprolol on central aortic pressure and left ventricular wall thickness. Hypertension. 2011 Jun;57 (6):1122–8.
  25. Mahmud A, Feely J. Beta-blockers reduce aortic stiffness in hypertension but nebivolol, not atenolol, reduces wave reflection. Am J Hypertens. 2008 Jun;21 (6):663–7.
  26. Mengden T, Vetter W. The efficacy of bisoprolol in the treatment of hypertension. Rev Contemp Pharmacother. 1997; 8:55–67.
  27. Williams A, Kenny D, Wilson D, Fagenello G, Nelson M, Dunstan F et al. Effects of atenolol, perindopril and verapamil on haemodynamic and vascular function in Marfan syndrome – a randomised, double-blind, crossover trial. Eur J Clin Invest. 2012 Aug;42 (8):891–9.
  28. Topouchian J, Asmar R , Sayegh F, Rudnicki A, Benetos A, Bacri AM, Safar ME. Changes in arterial structure and function under trandolapril-verapamil combination in hypertension. Stroke. 1999 May;30 (5):1056–64.
  29. Deary AJ, Schumann AL, Murfet H, Haydock S, Foo RS, Brown MJ. Influence of drugs and gender on the arterial pulse wave and natriuretic peptide secretion in untreated patients with essential hypertension. Clin Sci (Lond). 2002 Nov;103 (5):493–9.
  30. Janner JH, Godtfredsen NS, Ladelund S, Vestbo J, Prescott E. High aortic augmentation index predicts mortality and cardiovascular events in men from a general population, but not in women. Eur J Prev Cardiol. 2013 Dec;20 (6):1005–12.
  31. Mitchell GF, Hwang SJ, Vasan RS, Larson MG, Pencina MJ, Hamburg NM et al. Arterial stiffness and cardiovascular events: the Framingham. Heart Study. Circulation. 2010 Feb 2;121 (4):505–11.
  32. Vlachopoulos C, Aznaouridis K, O'Rourke MF, Safar ME, Baou K, Stefanadis C. Prediction of cardiovascular events and all-cause mortality with central haemodynamics: a systematic review and meta-analysis. Eur Heart J. 2010 Aug;31 (15):1865–71.
  33. London GM, Asmar RG, O'Rourke MF, Safar ME. Mechanism (s) of selective systolic blood pressure reduction after a low-dose combination of perindopril/indapamide in hypertensive subjects: comparison with atenolol. J Am Coll Cardiol. 2004 Jan 7;43 (1):92–9.
  34. Asmar R , Topouchian J, Pannier B, Benetos A, Safar M. Pulse wave velocity as endpoint in large-scale intervention trial. The COMPLIOR study. Scientific, Quality Control, Coordination and Investigation Committees of the Complior Study. J Hypertens. 2001 Apr;19 (4): 813–8.
  35. Benetos A, Adamopoulos C, Bureau JM, Temmar M, Labat C, Bean K et al. Determinants of accelerated progression of arterial stiffness in normotensive subjects and in treated hypertensive subjects over a 6-year period. Circulation. 2002 Mar 12;105 (10):1202–7.
  36. Giannattasio C, Vincenti A, Failla M, Capra A, Ciro A, De Ceglia S et al. Effects of heart rate changes on arterial distensibility in humans. Hypertension. 2003 Sep;42 (3):253–6.
  37. Sa Cunha R , Pannier B, Benetos A, Siche JP, London GM, Mallion JM, Safar ME. Association between high heart rate and high arterial rigidity in normotensive and hypertensive subjects. J Hypertens. 1997 Dec;15 (12 Pt 1):1423–30.
  38. Kim EJ, Song WH, Lee JU, Shin MS, Lee S, Kim BO et al. Efficacy of losartan and carvedilol on central hemodynamics in hypertensives: a prospective, randomized, open, blinded end point, multicenter study. Hypertens Res. 2014 Jan;37 (1):50–6.
  39. Asmar RG, Kerihuel JC, Girerd XJ, Safar ME. Effect of bisoprolol on blood pressure and arterial hemodynamics in systemic hypertension. Am J Cardiol. 1991 Jul 1;68 (1):61–4.
  40. Kähönen M, Ylitalo R , Kööbi T, Turjanmaa V, Ylitalo P. Influences of nonselective, β1-selective and vasodilatory β1-selective β-blockers on arterial pulse wave velocity in normotensive subjects. Gen Pharmacol. 2000 Oct;35 (4):219–24.
  41. Breithaupt-Grögler K, Gerhardt G, Lehmann G, Notter T, Belz GG. Blood pressure and aortic elastic properties – verapamil SR/trandolapril compared to a metoprolol/hydrochlorothiazide combination therapy. Int J Clin Pharmacol Ther. 1998 Aug;36 (8):425–31.
Orlova Ia.A., Mikhaylov G.V., Vitsenya M.V. Comparative effects of bisoprolol and verapamil on central and peripheral BP in patients with arterial hypertension. Russian Heart Journal. 2017;16 (1):59–65.

To access this material please log in or register

Register Authorize
Ru En