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Effects of Celiprolol and Bisoprolol on Blood Pressure, Vascular Stiffness, and Baroreflex Sensitivity
Kazuo Eguchi1, Satoshi Hoshide2, Kazuomi Kario2
1Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University, Shimotsuke, Tochigi, Japan. ke112@jichi.ac.jp.
Insights
Bisoprolol and celiprolol both lower blood pressure in hypertensives. Bisoprolol improved vascular stiffness and baroreflex sensitivity, while celiprolol reduced central blood pressure.
Area of Science:
- Cardiology
- Pharmacology
Background:
- Celiprolol and bisoprolol are beta-blockers with potential differential effects.
- Hypertension management requires understanding drug-specific impacts on vascular health.
Purpose of the Study:
- To compare the effects of add-on celiprolol versus bisoprolol on blood pressure, flow-mediated dilation, and vascular stiffness in treated hypertensive patients.
Main Methods:
- 102 hypertensive patients (not on beta-blockers) were randomized to add-on celiprolol or bisoprolol for 3 months.
- Assessed clinic, home, and ambulatory blood pressure, flow-mediated dilation (FMD), radial augmentation index (AI), brachial-ankle pulse wave velocity (baPWV), and baroreflex sensitivity (BRS).
Main Results:
- Both groups showed significant reductions in home and 24-hour blood pressure.
- Bisoprolol significantly reduced pulse rate, baPWV, and improved BRS and radial AI.
- Celiprolol significantly reduced central blood pressure, while both increased FMD.
Conclusions:
- Bisoprolol demonstrated superior effects on heart rate, vascular stiffness, and baroreflex sensitivity.
- Celiprolol effectively lowered central blood pressure.
- Celiprolol may suit uncomplicated hypertension, whereas bisoprolol could benefit patients with vascular disease and sympathetic activation.
Background:
We tested the hypothesis that celiprolol and bisoprolol have differential effects on blood pressure (BP), flow-mediated dilation (FMD), and vascular stiffness.
Methods:
We analyzed 102 hypertensives (mean age: 59±14 years) who were being treated other than beta-blockers. They were randomized to receive add-on treatment with either celiprolol 100-200mg (C group) or bisoprolol 2.5-5mg (B group), and followed up for 3 months. In addition to clinic, home, and ambulatory BP monitoring, the FMD, radial augmentation index (AI), brachial-ankle pulse wave velocity (baPWV), urine albumin-to-creatinine ratio, and baroreflex sensitivity (BRS) were measured at baseline and at the end of the study.
Results:
Compared to the baseline values, home and 24-hour BP were significantly lowered in the third month in both groups (all Ps < 0.05). Pulse rate (PR) and baPWV were reduced (P < 0.001), and BRS was increased significantly only in the B group (P = 0.02). Radial AI was unchanged in the C group but was significantly increased in the B group (P < 0.001). Central BP was significantly reduced in the C group (P = 0.003) but was unchanged in the B group. FMD was significantly increased in both groups (both P < 0.01).
Conclusion:
Bisoprolol achieved the greater reduction of PR and improved BRS and vascular stiffness, whereas, celiprolol reduced the central BP level. In treated hypertensive patients, add-on use of celiprolol may be favorable in uncomplicated stage of hypertension. On the other hand, bisoprolol may be useful in hypertensives with cardiac or vascular diseases who have advanced atherosclerotic changes and sympathetic nervous system activation.
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