Comparison of atenolol versus bisoprolol with noninvasive hemodynamic and pulse wave assessment

Area of Science:

• Cardiology
• Pharmacology
• Hypertension Management

Background:

• Beta-blockers are commonly prescribed for hypertension.
• Atenolol and bisoprolol are widely used beta-adrenergic blocking agents.
• Understanding their comparative hemodynamic effects is crucial for clinical practice.

Purpose of the Study:

• To compare the hemodynamic effects of atenolol and bisoprolol in patients with hypertension.
• To evaluate their impact on central-peripheral blood pressure, pulse wave analysis, and arterial stiffness.

Main Methods:

• Open-label, crossover study design.
• 19 hypertensive patients (untreated or on stable monotherapy) were randomized.
• Patients received either atenolol or bisoprolol for 4 weeks, then switched medications.
• Hemodynamic parameters, including pulse wave analysis and impedance cardiography, were assessed at baseline and after each treatment period.

Main Results:

• Both atenolol and bisoprolol significantly increased augmentation index and ejection duration.
• Both drugs reduced heart rate, brachial systolic and diastolic blood pressure, and central diastolic blood pressure.
• Neither drug significantly altered central systolic blood pressure.
• Stroke volume was significantly increased by both medications.
• No significant differences were observed between atenolol and bisoprolol.

Conclusions:

• Atenolol and bisoprolol exhibit similar hemodynamic profiles in hypertensive patients.
• The inability to decrease central systolic blood pressure may be attributed to drug-induced bradycardia, increased stroke volume, and early reflected aortic waves.