Comparative evaluation of the influence of ivabradine and atenolol on arterial wall stiffness in patients with stable angina and hypertension
Objective. To compare the effects of ivabradine and atenolol on arterial wall stiffness in patients with stable angina and arterial hypertension.Material and methods. The study included 31 patients (57.1% male), mean age 61.9 ± 8.4 years, with sinus rhythm, stable angina II-III functional class and hypertension, without previous myocardial infarction and heart failure/left ventricu- lar dysfunction. Before and during treatment we evaluated frequency of angina attacks, blood pressure, ECG and appla- nation tonometry, in which pulse wave velocity in the carotid- femoral segment, systolic, diastolic and pulse blood pressurein the aorta, the index of the augmentation in the aorta (IA), IAnormalized to heart rate 75 beats / min (IA75) were studied.Results. After treatment with ivabradine and atenolol thefrequency of angina attacks per week decreased by 89.0 and68.5% (p = 0.001), heart rate by 27,1% and 27,5%, SBPfrom 132.0 to 129.5 and from 132.0 to 122.0 (p = 0.001) mmHg, respectively. PWV in two groups decreased by 8,9% (p =0.002) and 10.4% (p = 0.002), central SBP by 5,4% (p =0.010) and 6,3% (p = 0.002 H), IA75 from 25.0 to 11.5 (p =0.008) and from 27.0 to 25.0 (p = 0.48) %, respectively.However сentral pulse pressure in ivabradine group decreasedby 8,8% (p = 0.638), while in atenolol group it increased by12,8% (p = 0.045).Conclusion. Both ivabradine and atenolol decrease heartrate, have antianginal and anti-ischemic effects, decreasePWV, that reflects arterial wall stiffness. Compared withatenolol, ivabradine reduces blood pressure in the aorta with-out affecting the peripheral blood pressure. This effect isprobably due to the ability of the drug to reduce central aug-mentation index.