LEFT-VENTRICULAR AND AORTIC ROOT STRUCTURE AND FUNCTION CHANGES WITH BETA-BLOCKER ANTIHYPERTENSIVE THERAPY - A ONE-YEAR DOUBLE-BLIND-STUDY OF CELIPROLOL AND METOPROLOL

Using echocardiographic and Doppler methodology, we evaluated the effe cts of celiprolol 200-400 mg/day and metoprolol 100-200 mg/day, given for one year, on haemodynamics, left ventricular structure and functio n, and aortic root distensibility in 40 hypertensive patients. Total p eripheral resistance was unchanged with metoprolol (-1.7%) but decreas ed with celiprolol (-11.2%), a significant difference between the two treatments (P = 0.01). Left ventricular mass index was reduced by 5.7% in those patients receiving metoprolol and by 11.8% in those receivin g celiprolol (P < 0.001). Cardiac index fell significantly with metopr olol and marginally with celiprolol (-13.9% vs. 5.9%, P = 0.003). Left ventricular diastolic function - as shown by the transmitral early to late peak filling velocity ratio - was not altered with metoprolol, b ut a significant increase (17%, P = 0.2) was seen with celiprolol, Bot h metoprolol and celiprolol increased aortic root distensibility, with celiprolol having a significantly greater effect (80% vs. 30%, P < 0. 01). We conclude that, in comparison to metoprolol, long term antihype rtensive therapy with celiprolol improves left ventricular diastolic a nd aortic root function, whilst reducing total peripheral resistance a nd left ventricular hypertrophy.