Association Between β1-Selective Beta-Blocker Use and P-Wave Terminal Force in Lead V1 in Hypertensive Patients With...

P-wave terminal force in lead V1 (PTFV1) is an electrocardiographic marker of atrial electrical abnormality. We investigated whether β1-selective beta-blocker use was associated with PTFV1 in hypertensive patients with echocardiographically confirmed left ventricular hypertrophy (LVH).

This retrospective study included 182 eligible patients with essential hypertension and LVH selected from 1372 screened patients. Patients were classified as β1-selective beta-blocker users (n = 82) or nonusers (n = 100). Abnormal PTFV1 was defined as ≥ 0.04 mm s. Multivariable regression and sensitivity analyses were performed.

PTFV1 was lower in beta-blocker users than in nonusers (0.024 [0.015-0.036] vs. 0.030 [0.020-0.048] mm s, p = 0.005). In the primary adjusted model, beta-blocker use was associated with lower PTFV1 (B = -0.008, standardized β = -0.202, 95% CI -0.014 to -0.002, p = 0.009), although model explanatory capacity was limited (R ² = 0.064; adjusted R ² = 0.021; overall p = 0.168). In an extended sensitivity analysis additionally adjusting for diabetes, renal function, and concomitant antihypertensive therapies, beta-blocker group status remained associated with lnPTFV1 (standardized β = 0.294, p < 0.001; R ² = 0.147; adjusted R ² = 0.081; overall p = 0.011). Beta-blocker use was also associated with lower odds of abnormal PTFV1 (OR = 0.43, 95% CI 0.22-0.84, p = 0.013).

β1-Selective beta-blocker use was associated with lower PTFV1 and a lower likelihood of abnormal PTFV1. These findings suggest a more favorable atrial electrical profile but should be considered hypothesis-generating given the retrospective design and modest model explanatory capacity.