NEBIVOLOL BUT NOT METOPROLOL DECREASES CENTRAL BLOOD PRESSURE AND LEFT VENTRICULAR WALL THICKNESS IN PATIENTS WITH ESSENTIAL HYPERTENSION: PP.10.411

Abstract

Objective: It has been demonstrated that the vasodilating β-blocker nebivolol (NEB) significantly reduces central blood pressure (BP) compared to atenolol, despite their similar effects on peripheral BP. However, no such data has been published on metoprolol (MET), which is a more widely used cardioselective β-blocker in our region. The main aim of the present study was to compare the effects of the β-blocker NEB and MET succinate on central BP, arterial stiffness and left ventricular wall thickness in patients with essential hypertension. Methods: A total of 80 patients (41 male and 39 female) aged 30–65 years, who had never been treated for mild to moderate essential hypertension, were randomized into two treatment groups receiving either NEB 5 mg or MET succinate 50–100 mg daily for 12 months. Central BP, augmentation index (AIx) and carotid-femoral pulse wave velocity (PWV) were measured (Sphygmocor Px, AtCor) and echocardiographic examination was performed (Sonos 7500, Philips) at baseline and at the end of the study. Results: NEB and MET significantly reduced heart rate, brachial systolic BP and diastolic BP to the same degree. However, reduction in central systolic BP (p = 0.0006), central diastolic BP (p = 0.01) and central pulse pressure (p = 0.0025) was significant only in the NEB group. Moreover, there was a significant reduction of left ventricular posterior wall thickness (p = 0.0002) and a trend for reduction of left ventricular septal wall thickness (p = 0.06) only in the NEB group. No significant changes in AIx or PWV were detected in either treatment group. Conclusion: Our study expands earlier observations and shows that despite the similar effect of both drugs on brachial BP and arterial stiffness, NEB has a greater impact on central BP and left ventricular wall thickness than MET. Thus, β-blockers with vasodilating properties, such as NEB, may offer a clear advantage over conventional β-blockers in antihypertensive therapy.