The Effect of Low-Dose Carvedilol, Nebivolol, and Metoprolol on Central Arterial Pressure and Its Determinants: A Randomized Clinical Trial

Péter Studinger, Ádám G. Tabák, Chen Huan Chen, Paolo Salvi, Taha E.H. Othmane, Péter Torzsa, Judit Kapocsi, Bertalan C. Fekete, András Tislér

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16 Citations (Scopus)

Abstract

In this prospective, open-label, randomized, controlled clinical trial the effects of low-dose carvedilol, nebivolol, and metoprolol on central arterial pressure and augmentation index (AIx) and its heart rate-corrected value (AIx@75) were assessed. The authors randomized 75 hypertensive patients (18-70 years) to carvedilol 12.5/25 mg, metoprolol 50/100 mg, or nebivolol 2.5/5 mg daily and followed them up for 3 months. Central arterial pressure and AIx were measured with applanation tonometry at baseline and at the end of follow-up. Analyses were restricted to 60 completers. Central systolic pressure decreased equally in all 3 treatment arms. AIx remained unchanged, while AIx@75 decreased significantly by 5.4%±2.5% in the nebivolol group. According to general linear models, individual change in heart rate was a strong predictor of change in AIx in the carvedilol group (r2=0.23, P=.03) although no similar association was found in the nebivolol group (r2=0.09). The impact of β-blockers with vasodilator effects on pressure augmentation seems to be different with nebivolol having the largest potential of decreasing AIx@75. While AIx changes associated with carvedilol treatment are strongly driven by heart rate changes, those associated with nebivolol treatment seem to be the result of other mechanisms.

Original languageEnglish
Pages (from-to)910-917
Number of pages8
JournalJournal of Clinical Hypertension
Volume15
Issue number12
DOIs
Publication statusPublished - Dec 1 2013

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Cardiology and Cardiovascular Medicine

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