Key result
Bisoprolol maintains cardiac output while atenolol reduces it by ~17% despite similar blood pressure lowering.
Why the study?
Does bisoprolol compared to atenolol improve systemic and renal hemodynamics and ambulatory blood pressure in patients with mild to moderate essential hypertension?
RCT (n=14)
double-blind
randomized cross-over
Does bisoprolol compared to atenolol improve systemic and renal hemodynamics and ambulatory blood pressure in patients with mild to moderate essential hypertension?
Bisoprolol and atenolol effectively lower blood pressure and preserve renal hemodynamics, though bisoprolol maintains cardiac output better than atenolol during short-term treatment.
Answers are grounded in this paper and cite their sources.
Supports preferring bisoprolol over atenolol to preserve cardiac output during BP lowering; extends comparative hemodynamic data among beta-blockers in hypertension.
The acute and short-term responses to bisoprolol and to atenolol on systemic and renal hemodynamics and on ambulatory blood pressure (BP) were compared in a randomized double-blind cross-over study including 14 patients with mild to moderate essential hypertension. After a 4-week placebo period, the patients received either bisoprolol (10 mg once daily, o.d.) or atenolol (100 mg o.d.) for 4 weeks and were switched to the other drug after a new 4-week placebo period. Cardiac output (CO) was measured by Doppler echography, and renal blood flow (RBF) and glomerular filtration rate (GFR) were measured by constant infusion techniques using [123I]iodohippurate and [51Cr]EDTA, respectively. Bisoprolol and atenolol decreased diurnal and nocturnal blood pressure (BP). Both drugs decreased heart rate (HR) and BP both acutely and after 4 weeks. During short-term treatment, CO was maintained with bisoprolol but reduced by atenolol (by 17%). RBF decreased after the first drug intake (by 9 and 12%, respectively) but returned to its baseline value after 4 weeks, so that calculated renal vascular resistance (RVR) was reduced (by 12 and 15%, respectively). Overall, GFR was not affected by treatment. Bisoprolol and atenolol are effective antihypertensive agents that preserve renal hemodynamics during short-term treatment.
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Leeman et al. (1993) conducted an RCT in mild to moderate essential hypertension (n=14). Bisoprolol vs. Atenolol (100 mg once daily) was evaluated on systemic and renal hemodynamics and ambulatory blood pressure. Bisoprolol and atenolol both decreased blood pressure and preserved renal hemodynamics, but short-term atenolol reduced cardiac output by 17% whereas bisoprolol maintained it.
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