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One-Year Renal and Cardiac Effects of Bisoprolol versus Losartan in Recently Diagnosed Hypertensive Patients

A Randomized, Double-Blind Study

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Abstract

Background and objectives: Hypertension is a significant cause of chronic renal injury and its effective treatment is capable of reducing the rate of renal failure. β-Adrenoceptor antagonists (β-blockers) have been reported to induce a deterioration in renal function, while several data have indicated a renoprotective effect of treatment with the angiotensin II type 1 receptor antagonist losartan. Previous studies of the interaction between the selective β1-blocker bisoprolol and kidney function were performed only for short-and medium-term periods. The aim of this study was to compare the antihypertensive efficacy and renal and cardiac haemodynamic effects of bisoprolol with those of losartan over a 1-year time period in patients with essential hypertension.

Methods: Seventy-two patients (40 males) with recently diagnosed uncomplicated (European Society of Hypertension [ESH] criteria stage 1–2) hypertension (mean ± SD age 52 ± 12 years) were enrolled in the study. After a run-in period of 14 days on placebo, the patients were randomized in a double-blind, prospective study to receive either bisoprolol 5 mg or losartan 50 mg, administered once daily for 1 year. At recruitment and 12 months after treatment, cardiac output and renal haemodynamics and function were evaluated by echocardiography and radionuclide studies, respectively.

Results: There were no significant differences in baseline clinical data, including glomerular filtration rate and blood pressure, between the two treatment groups. At 1 year, blood pressure had decreased significantly (p < 0.001) with both treatments, and heart rate was reduced only in the group taking bisoprolol. The long-term effects on renal haemodynamics and cardiac function were similar with both drugs, the only change being a significant reduction in the filtration fraction for each group.

Conclusions: These data suggest that both bisoprolol and losartan are effective agents for the treatment of patients with recently diagnosed ESH stage 1–2 hypertension. Over a 1-year period, both agents maintained good renal and cardiac performance and haemodynamics.

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Acknowledgements

No sources of funding were used to assist in the conduct of this study. The authors have no conflicts of interest that are directly related to the content of this study. The authors would like to acknowledge the cooperation and invaluable efforts of the physicians and nursing staff, in particular Mr Domenico Benanti and Mr Antonino Simonetta, in the Internal and Specialist Medicine Department at the University Hospital of Palermo.

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Authors and Affiliations

  1. Internal and Specialist Medicine Department, University Hospital of Palermo, Piazza delle Cliniche 2, 90120, Palermo, Italy

    Gaspare Parrinello (Associate Professor of Internal Medicine, Chair of Physiopathology Medicine), Daniele Torres, Manuela Mezzero, Mauro Cardillo, Caterina Trapanese & Giuseppe Licata

  2. Department of Emergency Care, University of Palermo, Palermo, Italy

    Salvatore Paterna, Gabriella La Rocca & Mario Caradonna

  3. Division of Cardiology, GF Ingrassia Hospital, Palermo, Palermo, Italy

    Pietro Di Pasquale

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  1. Gaspare Parrinello
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Correspondence to Gaspare Parrinello.

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Parrinello, G., Paterna, S., Torres, D. et al. One-Year Renal and Cardiac Effects of Bisoprolol versus Losartan in Recently Diagnosed Hypertensive Patients. Clin. Drug Investig. 29, 591–600 (2009). https://doi.org/10.2165/11315250-000000000-00000

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