A meta-analytical comparison of atenolol with angiotensin-converting enzyme inhibitors on arterial stiffness, peripheral blood pressure and heart rate in hypertensive patients

ABSTRACT

Objectives: This meta-analysis of randomized parallel controlled trials was designed to compare the efficacy of atenolol with angiotensin-converting enzyme inhibitors (ACEIs) in changing pulse wave velocity (PWV), peripheral blood pressure and heart rate (HR) among patients with essential hypertension. Methods: This study was conducted according to the PRISMA guideline. Data collection was independently completed by two investigators. Statistical analyses were completed by Stata software (v12.0). Results: Eight clinical trials were meta-analyzed in this study. Overall changes in PWV (weighted mean difference or WMD = 0.068, 95% confidence interval or CI: −0.487 to –0.623, P = 0.811) and peripheral systolic blood pressure (PSBP) (WMD = −1.281 mmHg, 95% CI: −6.936 to 4.375, P = 0.657) did not differ significantly between atenolol and ACEIs treatment. Relative to ACEIs, atenolol had a more favorable impact on peripheral diastolic blood pressure (PDBP) (WMD = −1.912 mmHg, 95% CI: −3.732 to −0.091, P = 0.040) and HR (WMD = −9.23 bpm, 95% CI: −12.53 to −5.93, P < 0.001). In stratified analyses, particularly by follow-up period, atenolol was observed to be superior over ACEIs within early 3-month treatment in PSBP (WMD = −4.097 mmHg, 95% CI: −6.589 to −1.605, P = 0.001), PDBP (WMD = −6.802 mmHg, 95% CI: −8.517 to −5.087, P < 0.001) and HR (WMD = −14.242 bpm, 95% CI: −16.427 to −12.058, P = 0.028), without heterogeneity (I² = 0.0%). There were low probabilities of publication bias for all comparisons. Conclusions: Our findings demonstrate that atenolol and ACEIs were equally effective in reducing PWV and PSBP, while atenolol was superior over ACEIs in improving PDBP and HR, especially within short-term treatment.

KEYWORDS:

• Atenolol
• angiotensin-converting enzyme inhibitor
• arterial stiffness
• heart rate
• peripheral blood pressure

Disclosure statement

The authors declare no conflicts of interest, and the authors alone are responsible for the content and writing of the paper.

Funding

This work was supported by the Natural Science Foundation of Fujian Province (2015J01451) and the Training Project for Young and Middle-Aged Core Talents of Health System of Fujian Province (2015-ZQN-JC-22).

Additional information

Funding

This work was supported by the Natural Science Foundation of Fujian Province (2015J01451) and the Training Project for Young and Middle-Aged Core Talents of Health System of Fujian Province (2015-ZQN-JC-22).