Objective: To evaluate ventricular-arterial coupling in hypertensive patients after therapy with a beta-blocker and its fixed dose combination (FDC) with amlodipine.

Design and method: 28 patients (age 53,95±7,2, 20 males, BP 148,7±13,4/96,6±14,1 mmHg, HR 83,2±10,1 bpm) with untreated uncomplicated hypertension underwent simultaneous EchoCG and blood pressure (BP) acquisition at baseline, after 4 weeks of bisoprolol 5–10 mg monotherapy and after 8 weeks after switching to FDC bisoprolol 5–10/amlodipine 5–10 mg. Doses were titrated to reach BP <140/90 mmHg. Arterial elastance (Ea) and LV elastance (Ees) at rest were calculated as end-systolic pressure (ESP)/stroke volume (SV) and ESP/end-systolic volume (ESV). Ventricular-arterial coupling (VAC) was assessed as Ea/Ees. Mechanical efficiency of left ventricle (ELV) and peripheral arterial resistance (PAR) were evaluated also. p<0,05 was considered significant.

Results: After monotherapy with bisoprolol BP was 146,1±15,3/85,3±11,3 mmHg (p>0,05 vs baseline), HR 59,8±7,7 (p<0,05 vs baseline), after FDC 132,1±11,3/76,23±11,1 mmHg and 64,54±7,0 bpm, respectively (all p<0,05 vs baseline). Bisoprolol decreased Ees from 4,45±1,9 to 3,67±0,98 (p<0,05) whereas Ea, PAR did not change significantly. Ea/Ees increased significantly from 0,47±0,16 to 0,55±0,14 (p<0,05). Switching to bisoprolol/amlodipine FDC resulted in decrease of Ea from 1,88±0,39 at baseline and from 1,92±0,38 after bisoprolol monotherapy, PAR from 137,1±35,3 at baseline and from 128,9±36, respectively to 105,6±28. Ees did not change from that on bisoprolol, Ea/Ees (0,45±0,1) returned to baseline values. ELV did not change significantly throughout a study.

Conclusions: In hypertensive patients monotherapy with bisoprolol reduces initially increased Ees without negative effect on Ea and PAR and switching to bisoprolol/amlodipine FDC results in additional Ea reduction. Thus the study confirms potential benefits of bisoprolol/amlodipine in arterial hypertension in terms of cardiovascular functioning.