Effect of atenolol vs metoprolol succinate on vascular function in patients with hypertension.

Author(s): Heffernan KS, Suryadevara R, Patvardhan EA, Mooney P, Karas RH, Kuvin JT

Affiliation(s): Vascular Function Study Group, Department of Medicine, Division of Cardiology, Molecular Cardiology Research Institute, Tufts Medical Center, Boston, Massachusetts, USA. kheffernan@tuftsmedicalcenter.org

Publication date & source: 2011-01, Clin Cardiol., 34(1):39-44.

Publication type: Comparative Study; Randomized Controlled Trial; Research Support, N.I.H., Extramural

BACKGROUND: We evaluated the effect of atenolol vs metoprolol succinate on vascular function in patients with essential hypertension. HYPOTHESIS: Given intrinsic differences between these agents, we hypothesized that atenolol and metoprolol succinate would have disparate effects on vascular function. METHODS: This study included 24 patients with hypertension (age 56 +/- 2 years, 8 female, body mass index 28 +/- 1) and featured a randomized, double-blind, crossover design. Each beta-blocker (atenolol or metoprolol succinate) was taken by patients once daily for a 4-week period. Measures of vascular function included peripheral augmentation index (AIx) and pulse wave amplitude reactive hyperemia index from peripheral arterial tonometry, and brachial artery flow-mediated dilation from ultrasound. RESULTS: There were similar reductions in mean arterial pressure following treatment with atenolol and metoprolol succinate. Compared with metoprolol succinate, there was a significant increase in peripheral AIx following atenolol therapy (P < 0.05). There were no changes in brachial artery flow-mediated dilation or pulse wave amplitude reactive hyperemia index following either drug treatment. CONCLUSIONS: Although atenolol and metoprolol succinate have similar effects on blood-pressure reduction, they have different effects on vascular function. Compared with metoprolol succinate, atenolol increases peripheral AIx. Neither drug has an effect on vascular endothelial function. These findings may have clinical implications, depending on the indication for treatment in an individual patient. (c) 2011 Wiley Periodicals, Inc.