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Impact of Antihypertensive Agents on Central Systolic Blood Pressure and Augmentation Index: A Meta-Analysis

Tracey J McGaughey1, Emily A Fletcher1, Sachin A Shah2

  • 1Department of Pharmacy, David Grant Medical Center, Travis Air Force Base Fairfield, California, USA;

American Journal of Hypertension
|August 21, 2015
PubMed

Insights

Beta-blockers (BBs) are less effective than other antihypertensives in lowering central systolic blood pressure (cSBP) and augmentation index (AI). This meta-analysis highlights differences in drug efficacy for cardiovascular risk markers.

Area of Science:

  • Cardiology
  • Pharmacology
  • Hypertension Research

Background:

  • Central systolic blood pressure (cSBP) and augmentation index (AI) are increasingly recognized as superior predictors of cardiovascular events compared to peripheral systolic BP (pSBP).
  • Understanding the differential impact of antihypertensive medications on these key cardiovascular markers is crucial for optimizing treatment strategies.

Purpose of the Study:

  • To conduct a meta-analysis evaluating the effects of various antihypertensive drug classes on cSBP and AI.
  • To compare the efficacy of different antihypertensives in reducing cSBP and AI.

Main Methods:

  • A systematic literature search of PubMed, Cochrane Library, and CINAHL was performed up to September 2014.
  • A random-effects model (DerSimonian and Laird) was employed to calculate weighted mean differences (WMD) and 95% confidence intervals (CI).
  • Data from 52 studies (4,381 subjects) for cSBP and 58 studies (3,716 subjects) for AI were analyzed.

Main Results:

  • Antihypertensives collectively reduced peripheral systolic BP (pSBP) more than cSBP (WMD 2.52 mm Hg).
  • Beta-blockers (BBs) showed a significantly greater reduction in pSBP compared to cSBP (WMD 5.19 mm Hg).
  • Most antihypertensive classes reduced cSBP and pSBP similarly, while several classes, including BBs, significantly reduced AI (overall reduction 3.09%).

Conclusions:

  • Beta-blockers (BBs) demonstrate less benefit in reducing cSBP and AI compared to other antihypertensive agents.
  • The findings suggest that the choice of antihypertensive medication may influence its effectiveness in improving central hemodynamic markers associated with cardiovascular risk.
Abstract

Keywords:
antihypertensiveaugmentation indexblood pressurecentral blood pressurehypertensionmeta-analysis.

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