Blood pressure lowering efficacy of beta-blockers as second-line therapy for primary hypertension

Chen, Jenny Mh; Heran, Balraj S; Perez, Marco I; Wright, James M

doi:10.1002/14651858.cd007185.pub2

Cited by 29 publications

(16 citation statements)

References 47 publications

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“…Therefore, our noted associations between DHA and both diastolic BP and resting pulse (and near significant trends for ambulatory pulse) may reflect this early phase of hypertension development. While an association with systolic BP might also be expected, the observed relationship between DHA and specifically diastolic BP parallels a greater effect of beta blocker medications on diastolic BP when compared to thiazide diuretics and calcium channel blockers [34, 35] .…”

Section: Discussionmentioning

confidence: 99%

Long-Chain Omega-3 Fatty Acids and Blood Pressure

Liu

Conklin

Manuck

et al. 2011

American Journal of Hypertension

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Objective High dose fish oil supplementation reduces blood pressure (BP) in hypertensive patients. The current study examines how modest variations in omega-3 fatty acid intake may affect BP in a healthy community sample. Methods Study participants included 265 Pittsburgh-area adults 30–54 years of age (11% black, 51% female) not taking omega-3 fatty acid supplements or antihypertensive medications. Standardized assessments of clinic and 24-hour ambulatory BP, and pulse rate were obtained. Docosahexanenoic acid (DHA) and eicosapentaenoic acid (EPA) in fasting serum phospholipids were measured by capillary gas chromatography. Regression analyses controlled for age, gender, race, BMI, self-reported sodium intake and physical activity. Results Participants included 181 (68%) normotensives, 64 (25%) prehypertensives, and 18 (7%) persons with untreated hypertension. DHA was inversely associated with clinic diastolic (β=−0.121, p= 0.03), awake ambulatory diastolic BP (β=−0.164, p= 0.004), and 24-hour diastolic BP (β=−0.135, p=0.02). A two standard deviation greater DHA was associated with 2.1 mm Hg lower clinic and 2.3 mm Hg lower awake ambulatory diastolic BP. In addition, DHA was inversely associated with pulse rate measured at rest in the clinic. EPA was related to clinic pulse rate but not clinic or ambulatory BP. Conclusion In this sample of American adults not on antihypertensive medications, a modest, inverse association was found between DHA exposure and both clinic and ambulatory diastolic BP. Therefore, increasing DHA consumption through diet modification rather than large dose supplementation represents a candidate strategy for future studies of hypertension prevention.

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Section: Discussionmentioning

confidence: 99%

Long-Chain Omega-3 Fatty Acids and Blood Pressure

Liu

Conklin

Manuck

et al. 2011

American Journal of Hypertension

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“…[27][28][29] A number of trials have reported a necessity to use multiple antihypertensive agents for effective maintenance of BP. 30 Targeting more than 1 pressor pathway via the use of combination therapies of different antihypertensive drug classes overcomes many of the limitations associated with monotherapy. 29 Treatment guidelines recommend a wide variety of antihypertensive drug combinations, the choice of which depends on the clinical characteristics of the patient, with combinations of all major classes suitable for specific populations.…”

Section: Combination Therapies Allow Effective Management Of Hypertenmentioning

confidence: 99%

“…3,30 Although randomized clinical trials are limited, results from noninterventional trials have provided evidence that the FDC of bisoprolol and amlodipine is an effective treatment for hypertension, as summarized in Table 1. Nevertheless, it is generally accepted that the BP-lowering action of antihypertensives is itself an important factor for improving long-term outcomes.…”

Section: A Summary Of Bisoprolol + Amlodipine Fdc Efficacy and Safetymentioning

confidence: 99%

Management of Hypertension With a Fixed‐Dose (Single‐Pill) Combination of Bisoprolol and Amlodipine

Gottwald-Hostalek

Sun

Barho³

et al. 2016

Clinical Pharm in Drug Dev

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Hypertension is currently one of the greatest global health care challenges. Although many effective drugs are available, combinations of 2 or more medications are often required to meet clinical targets. Combination therapy has several advantages over monotherapy: lower doses of each drug can be used to achieve therapeutic goals; lower doses may lead to fewer adverse events, facilitating patient adherence; and using multiple drugs with different modes of action may be more effective in treating multifactorial diseases, including hypertension. Adherence is an important consideration when requiring patients to self-administer multiple medications; as the number of concurrent medications increases, patient adherence tends to decrease. Recent evidence suggests that fixed-dose combinations (FDCs) may be more effective than free-dose combinations, as they provide all necessary medications in a single convenient tablet/single-pill combination. Among combinations of hypertension medications, a β-blocker such as bisoprolol with a calcium channel blocker such as amlodipine is an effective combination therapy for hypertension, with distinct and complimentary modes of action. With advantages over free-dose combinations, the FDC of bisoprolol/amlodipine is thus an effective and convenient treatment for hypertension, allowing more patients to achieve their therapeutic goals, while potentially reducing the burden of hypertension on health care systems.

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“…Beta-blockers have often been combined with diuretics in RCTs and clinical practice. 124, 127 There are no theoretical reasons why beta-blockers should not be combined with ACE-Is or ARBs. 128 The combination of atenolol or bisoprolol (which accumulate in CKD patients) with bradycardia-inducing drugs such as non-dihydropyridine calcium-channel blockers is not recommended.…”

Section: Bp-lowering Agentsmentioning

confidence: 99%

Chapter 2: Lifestyle and pharmacological treatments for lowering blood pressure in CKD ND patients

2012

Kidney International Supplements

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Blood pressure lowering efficacy of beta-blockers as second-line therapy for primary hypertension

Cited by 29 publications

References 47 publications

Long-Chain Omega-3 Fatty Acids and Blood Pressure

Long-Chain Omega-3 Fatty Acids and Blood Pressure

Management of Hypertension With a Fixed‐Dose (Single‐Pill) Combination of Bisoprolol and Amlodipine

Chapter 2: Lifestyle and pharmacological treatments for lowering blood pressure in CKD ND patients

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