Letter by Nieminen et al Regarding Article, “Differential Impact of Blood Pressure-Lowering Drugs on Central Aortic Pressure and Clinical Outcomes: Principal Results of the Conduit Artery Function Evaluation (CAFE) Study”

The interesting article by Williams et al 1 convincingly shows that treatments based on atenolol and amlodipine differ substantially in their influences on central aortic pressures even in long-term treatment, despite having similar effects on brachial blood pressures. The authors conclude that this phenomenon is due to differences in the timing of systolic ejection caused by lower heart rate during treatment with the -blocker atenolol. This mechanism certainly has merit.