Objective: The aim of the study was to evaluate if combination with amlodipine eliminates the adverse effect of beta-blockers on aortic pulse pressure (PP) augmentation.

Methods: 28 previously untreated non-diabetic hypertensive subjects (age 53,6±5,7 years, 19 males) where treated bisoprolol 5–10 mg, if in 4 weeks BP >140/90 mmHg amlodipine 5 mg-10 mg was added to therapy to reach BP <140/90 mmHg. Before treatment, after monotherapy and after bisoprolol+amlodipin, applanation tonometry was done. The changes were considered significant if p<0,05.

Results: At the end of the study 23 patients were treated with bisoprolol 5/amlodipine 10 mg fixed dose combination, 5 – 10/10 mg. After 4 weeks of monotherapy brachial BP decreased from 153,9±9,1/83,4±7,5 to 146,7±8,3/85,1±3,4 mmHg, HR from 79,2±4,7 to 63,5±4,7 bpm (p<0,05). At the end of the study BP was 129,1±5,6/74,3±4,9 mmHg (p<0,05 vs baseline and monotherapy period), HR 62,8±4,9 bpm (p<0,05 vs baseline). Baseline central SBP was 143,2±8,2, PP 46,810,4 mmHg, augmentation index (AI)@HR 75 bpm 20±14%, PWV 10,5±2,1 m/s. After bisoprolol monotherapy the values were, respectively, 134±7,6, PP 44,2±7,3 mmHg, 27,1±16,1%, PWV 10,0±1,6 m/s. After further 4 weeks treatment with bisoprolo+amlodipine central SBP was 119,5±5,7 (p<0,05 vs baseline), PP 41,4±6,3 mmHg (p<0,05 vs baseline), AI@HR 75 bpm 21,9±6,5 % (p<0,05 vs baseline), PWV 9,6±1,0 m/s.

Conclusion: Monotherapy with bisoprolol increases central PP augmentation. Combining with amlodipine in a single pill eliminates the adverse effect of a beta-blocker on aortic PP augmentation and results in effective reduction of central SBP.