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Heart rate dependent and independent effects of beta-blockers on central hemodynamic parameters: a propensity score

Rémi Goupil1, Dominique Dupuis, Stéphan Troyanov

  • 1aHôpital du Sacré-Cœur de Montréal, Université de Montréal, Montreal bCHU de Québec, Hôtel-Dieu de Québec, Université Laval, Quebec City, Québec, Canada.

Journal of Hypertension
|May 25, 2016
PubMed

Insights

Beta-blockers may worsen central hemodynamics through heart rate-dependent and independent mechanisms. This study reveals that beta-blocker use is associated with an unfavorable central hemodynamic profile in treated hypertensive patients.

Area of Science:

  • Cardiovascular medicine
  • Pharmacology

Background:

  • Central hemodynamic parameters are superior predictors of cardiovascular risk compared to peripheral blood pressure.
  • Beta-blockers are hypothesized to reduce central blood pressure less effectively than peripheral blood pressure, potentially due to heart rate reduction.

Purpose of the Study:

  • To investigate the association between beta-blocker use, heart rate, and central hemodynamic indices in treated hypertensive individuals.
  • To elucidate the mechanisms underlying the effects of beta-blockers on central hemodynamics.

Main Methods:

  • Utilized propensity score matching and multivariate linear regressions on data from the CARTaGENE study.
  • Analyzed 2575 treated hypertensive patients with valid pulse wave analysis, matching 457 beta-blocker users with non-users.

Main Results:

  • Beta-blocker users exhibited less favorable central pulse pressure, pulse pressure amplification, augmentation index, and augmented pressure compared to non-users.
  • Adjusting for heart rate significantly altered the observed differences in central pulse pressure, indicating both heart rate-dependent and independent effects.

Conclusions:

  • The unfavorable central hemodynamic profile associated with beta-blocker use has both heart rate-dependent and independent components.
  • These findings were consistent across frequently used beta1-selective beta-blockers like atenolol, metoprolol, and bisoprolol.
Abstract

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