The differential effects of antihypertensive drugs on central blood pressure: Comparison between beta-blocker and ARB
Overview
- Phase
- 未知
- Intervention
- Not specified
- Conditions
- Diseases of the circulatory system
- Sponsor
- Korea University Anam Hospital
- Enrollment
- 97
- Status
- Completed
- Last Updated
- 3 years ago
Overview
Brief Summary
Background Central blood pressure and central pulse pressure have a better correlation with the risk of cardiovascular disease compared to those of peripheral measurement. In a previous study, a second-generation beta-blocker showed poor CBP-lowering effects. However, the effect on CBP by third-generation beta-blockers is not fully elucidated. Thus, this randomised study investigated whether nebivolol-based hypertension treatment may confer advantages over telmisartan, an angiotensin II receptor- blocker, in reducing CBP. Methods This was a prospective, randomised, multicentre, open-label, controlled trial that evaluated 98 hypertensive patients. Patients received either nebivolol- (N=49) or telmisartan-based (N=49) treatment for hypertension for 12 weeks with a target BP of =140/80. The primary outcome was the difference in change from baseline central systolic BP (cSBP) after 12 weeks. Results There were no significant differences between the two groups in baseline central and peripheral SBP. The mean change in cSBP from baseline (?cSBP) was -17.2±3 mmHg for nebivolol group (P<0.001) and -29.9±3 mmHg for telmisartan group (P<0.001). The difference in ?cSBP between the two groups was significant (12.7mmHg, 95% confidence interval [CI], 4.13 to 21.2; P=0.004). Peripheral SBP (pSBP) decreased less in nebivolol group compared to telmisartan group (-18.0±3 in nebivolol group vs. -26.3±3 in telmisartan group, P=0.032). Adjusting for changes in pSBP, while the difference between central and peripheral SBP (cSBP-pSBP) was insignificant between the two groups at baseline (7.5±1 in nebivolol group vs. 7.0±1 in telmisartan group, p=0.746), it was significantly higher at week 12 in telmisartan group (5.5±1 in nebivolol group vs. 7.4±1 in telmisartan group, p<0.001), showing a greater reduction in central BP in telmisartan group compared to nebivolol group. Conclusions Nebivolol-based hypertension treatment may have less potent CBP-lowering effects compared to telmisartan. However, larger-scale studies are warranted to further elaborate our findings.
Investigators
Eligibility Criteria
Inclusion Criteria
- •(1\) Patients between the ages of 40 and 80 (2\) Patients who are first diagnosed with high blood pressure corresponding to systolic blood pressure \= 140 mmHg or loosened blood pressure \= 90 mmHg (3\) Patients who have already undergone a wash out of a drug that had been used for two weeks if they were diagnosed with hypertension \= 140 mmHg or loosened blood pressure \= 90 mmHg (4\) Person who agrees to the purpose of this study and to provide clinical information
Exclusion Criteria
- •(1\) A person who has overreaction or withdrawal symptoms in the use of anti\-hypertension drugs such as beta\-blockers (2\) Severe hypertension patient corresponding to systolic blood pressure \= 200 mmHg or relaxation pressure \= 110 mmHg at any visit (3\) Medications that may affect blood pressure and central arterial pressure (disease, alpha\-blocking, etc.) are already being administered and cannot be stopped due to treatment of other diseases.
Outcomes
Primary Outcomes
Not specified