State Key Laboratory of Medical Genomics, Shanghai Key Laboratory of Hypertension and Department of Hypertension, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China ; Shanghai Institute of Hypertension, Shanghai, China ; Laboratory of Vascular Biology, Institute of Health Sciences, Shanghai Institutes for Biological Sciences, Chinese Academy of Sciences, Shanghai, China.
PLoS One. 2013 Sep 10;8(9):e72102. doi: 10.1371/journal.pone.0072102. eCollection 2013.
β-blockers (BBs) with different pharmacological properties may have heterogeneous effects on sympathetic nervous activity (SNA) and central aortic pressure (CAP), which are independent cardiovascular factors for hypertension. Hence, we analyzed the effects of bisoprolol and atenolol on SNA and CAP in hypertensive patients.
This was a prospective, randomized, controlled study in 109 never-treated hypertensive subjects randomized to bisoprolol (5 mg) or atenolol (50 mg) for 4-8 weeks. SNA, baroreflex sensitivity (BRS) and heart rate (HR) variability (HRV) were measured using power spectral analysis using a Finometer. CAP and related parameters were determined using the SphygmoCor device (pulse wave analysis).
Both drugs were similarly effective in reducing brachial BP. However, central systolic BP (-14±10 mm Hg vs -6±9 mm Hg; P<0.001) and aortic pulse pressure (-3±10 mm Hg vs +3±8 mm Hg; P<0.001) decreased more significantly with bisoprolol than with atenolol. The augmentation index at a HR of 75 bpm (AIxatHR75) was significantly decreased (29%±11% to 25%±12%; P = 0.026) in the bisoprolol group only. Furthermore, the change in BRS in the bisoprolol group (3.99±4.19 ms/mmHg) was higher than in the atenolol group (2.66±3.78 ms/mmHg), although not statistically significant (P>0.05). BRS was stable when RHR was controlled (RHR≤65 bpm), and the two treatments had similar effects on the low frequency/high frequency (HF) ratio and on HF.
BBs seem to have different effects on arterial distensibility and compliance in hypertensive subjects. Compared with atenolol, bisoprolol may have a better effect on CAP.
ClinicalTrials.gov NCT01762436.
具有不同药理学特性的β受体阻滞剂（BB）可能对交感神经活性（SNA）和中心主动脉压（CAP）产生异质性影响，而 SNA 和 CAP 是高血压的独立心血管因素。因此，我们分析了比索洛尔和阿替洛尔对高血压患者 SNA 和 CAP 的影响。
这是一项前瞻性、随机、对照研究，纳入 109 例从未接受治疗的高血压患者，随机分为比索洛尔（5mg）或阿替洛尔（50mg）组，治疗 4-8 周。使用 Finometer 通过功率谱分析测量 SNA、压力反射敏感性（BRS）和心率变异性（HRV）。使用 SphygmoCor 设备（脉搏波分析）测定 CAP 和相关参数。
两种药物均能有效降低肱动脉血压，但比索洛尔组中心收缩压（-14±10mmHg 比-6±9mmHg；P<0.001）和主动脉脉压（-3±10mmHg 比+3±8mmHg；P<0.001）下降更明显。只有比索洛尔组的心率为 75bpm 时的增强指数（AIxatHR75）显著降低（29%±11%至 25%±12%；P=0.026）。此外，比索洛尔组的 BRS 变化（3.99±4.19ms/mmHg）高于阿替洛尔组（2.66±3.78ms/mmHg），但差异无统计学意义（P>0.05）。当 RHR 得到控制（RHR≤65bpm）时，BRS 保持稳定，两种治疗方法对低频/高频（HF）比值和 HF 具有相似的作用。
β受体阻滞剂似乎对高血压患者的动脉扩张性和顺应性有不同的影响。与阿替洛尔相比，比索洛尔对 CAP 的影响可能更好。
ClinicalTrials.gov NCT01762436。
