Atenolol’s Inferior Ability to Reduce Central vs Peripheral Blood Pressure Can Be Explained by the Combination of Its Heart Rate-Dependent and Heart Rate-Independent Effects
Table 2
Effect of ß-blockers and ivabradine on hemodynamic parameters at the low heart rate level (AAI 40 bpm).
Parameter
Atenolol
Nebivolol
Ivabradine
value for baselines
value for difference
Heart rate, bpm
Baseline
48.64 ± 4.79
48.60 ± 5.25
49.58 ± 5.41
0.45
End
43.66 ± 3.53
47.02 ± 5.32
46.46 ± 4.95
Difference from baseline to end ( value; 95% CI)
4.98 ± 3.98 (<0.01; 3.34–6.62)
1.58 ± 2.59 (<0.01; 0.51–2.65)
3.12 ± 4.37 (<0.01; 1.32–4.92)
<0.01 (ate similar to ivb, neb similar to ivb)
Peripheral systolic blood pressure, mmHg
Baseline
129.64 ± 15.09
126.42 ± 13.86
126.46 ± 13.24
0.11
End
119.74 ± 14.95
121.94 ± 12.24
123.58 ± 11.42
Difference from baseline to end ( value; 95% CI)
9.90 ± 11.99 (<0.01; 4.95–14.85)
4.48 ± 7.91 (<0.01; 1.22–7.74)
2.88 ± 8.92 (0.12; −0.80–6.56)
0.02 (ate similar to neb, neb similar to ivb)
Central systolic blood pressure, mmHg
Baseline
120.08 ± 14.87
117.38 ± 13.11
117.66 ± 12.62
0.17
End
110.92 ± 14.09
112.88 ± 12.22
114.30 ± 11.80
Difference from baseline to end ( value; 95% CI)
9.16 ± 11.81 (<0.01; 4.28–14.04)
4.50 ± 7.62 (<0.01; 1.36–7.64)
3.36 ± 8.65 (0.06; −0.21–6.93)
0.06
Systolic blood pressure amplification, mmHg
Baseline
9.56 ± 2.70
9.04 ± 3.34
8.8 ± 2.94
0.28
End
8.82 ± 2.76
9.06 ± 2.72
9.28 ± 2.36
Difference from baseline to end ( value; 95% CI)
0.74 ± 1.58 (0.03; 0.09–1.40)
−0.02 ± 2.40 (0.99; −1.01–0.97)
−0.48 ± 1.88 (0.21; −1.26–0.30)
0.06
Values are presented as mean ± SD. Ate indicates atenolol; ivb, ivabradine; and neb, nebivolol.
