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Atenolol and eprosartan: differential effects on central blood pressure and aortic pulse wave velocity

Zahid Dhakam1, Carmel M McEniery, Yasmin

  • 1Clinical Pharmacology Unit, University of Cambridge, Addenbrooke's Hospital, Cambridge, England.

American Journal of Hypertension
|February 2, 2006
PubMed

Insights

Atenolol lowered peripheral blood pressure but not central blood pressure as effectively as eprosartan. This difference in hemodynamic effects may explain atenolol

Area of Science:

  • Cardiovascular medicine
  • Pharmacology
  • Hypertension research

Background:

  • Atenolol's efficacy in reducing cardiovascular risk in older hypertensive patients is debated.
  • Atenolol may be less effective than other antihypertensives in reducing central blood pressure (BP).

Purpose of the Study:

  • To compare the hemodynamic effects of atenolol and eprosartan.
  • To investigate differences in central BP reduction between atenolol and eprosartan.

Main Methods:

  • A double-blind, randomized, cross-over study involving 21 never-treated hypertensive subjects.
  • Assessment of central BP, augmentation index, and aortic pulse wave velocity.
  • 6 weeks of therapy with atenolol (50 mg) or eprosartan (600 mg) after a 2-week placebo run-in.

Main Results:

  • Both drugs similarly reduced peripheral BP.
  • Eprosartan showed a significantly greater reduction in central systolic BP compared to atenolol.
  • Atenolol reduced aortic pulse wave velocity more than eprosartan, but eprosartan significantly reduced augmentation index and N-terminal pro-brain natriuretic peptide levels.

Conclusions:

  • Atenolol's failure to reduce wave reflection limits its impact on central systolic BP compared to eprosartan.
  • These hemodynamic differences may explain atenolol's poorer outcomes in older patients with essential hypertension.
  • Eprosartan demonstrates a more favorable central hemodynamic profile than atenolol.
Abstract

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