OBJECTIVES Beta-blockers are widely used in the treatment of hypertension. Although decrease in heart rate has a major role in beta-blocker treatment, data are limited on the association between heart rate and the effectiveness of beta-blockers. This study was designed to evaluate the effect of basal heart rate on the efficiency of beta-blocker treatment in patients with essential arterial hypertension.
STUDY DESIGN This prospective study included 20 patients (13 males, 7 females, mean age 53±10 years) with grade I/II essential hypertension, who did not receive any antihypertensive drugs and did not have any disease affecting the heart rate. Following 24-hour ambulatory blood pressure monitoring for daytime and nighttime systolic, diastolic, and arterial blood pressures, and mean heart rates, oral metoprolol succinate treatment (50 mg/day) was started. At the end of 20 days, 24-hour ambulatory blood pressure monitoring was repeated.
RESULTS There were significant decreases in mean daytime systolic, diastolic, and arterial (p<0.001) blood pressures (p<0.001) with corresponding decreases in nighttime blood pressures (p=0.021, p=0.039, and p<0.001, respectively). Changes in daytime and nighttime mean heart rates were also significant (p<0.001). There was a significant correlation between the daytime basal heart rate and the decline in daytime arterial blood pressure (r=0.666, p=0.001). ROC (receiver operating characteristics) curve analysis showed that patients with a daytime basal heart rate of 72/min or higher had a significantly greater reduction in arterial blood pressure (p=0.04).
CONCLUSION Our results suggest that patients with higher basal heart rates benefit more from beta-blocker treatment for arterial hypertension.
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