Why the study?
Do different antihypertensive agents (amlodipine, bisoprolol, lisinopril) differentially affect systolic blood pressure and augmentation index in hypertensive liver transplant recipients?
Do different antihypertensive agents (amlodipine, bisoprolol, lisinopril) differentially affect systolic blood pressure and augmentation index in hypertensive liver transplant recipients?
Lisinopril is more effective than bisoprolol at reducing central aortic pressure and systolic blood pressure in hypertensive liver transplant recipients.
Answers are grounded in this paper and cite their sources.
Supports lisinopril over bisoprolol for SBP and AIx reduction in liver transplant hypertension; extends class effects on central hemodynamics to this population.
BACKGROUND: Hypertension is common after liver transplantation. There are few published data on optimum treatment. Augmentation index (AIx) is a measure of arterial wave reflection determined by pulse wave analysis. METHODS: Amlodipine was administered to 24 hypertensive liver transplant recipients. Thirteen patients intolerant of or unresponsive to amlodipine were randomized to a crossover study comparing bisoprolol with lisinopril. RESULTS: With amlodipine, systolic blood pressure (SBP) fell from 154+/-2 mm Hg to 130+/-2 mm Hg, and AIx also fell. With bisoprolol, SBP fell from 154+/-2 mm Hg to 142+/-4 mm Hg, but AIx increased. With lisinopril, SBP fell from 154+/-2 mm Hg to 130+/-5 mm Hg, and AIx also fell (P <0.001 throughout). CONCLUSIONS: Amlodipine is an effective treatment for hypertension. The increased AIx with bisoprolol indicates increased wave reflection such that central aortic pressure is reduced less than peripheral SBP. Lisinopril reduces AIx and reduces SBP more than bisoprolol and is the preferred drug.
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Neal et al. (2004) studied this question.
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