Beta-blocker treatment of patients with diastolic heart failure and arterial hypertension. A prospective, randomized, comparison of the long-term effects of atenolol vs. nebivolol

Eur J Heart Fail. 2003 Oct;5(5):621-7. doi: 10.1016/s1388-9842(03)00054-0.


We compared the effects of 6 months administration of atenolol or nebivolol on resting and exercise hemodynamic parameters and maximal exercise capacity, in 26 patients with hypertension and left ventricular (LV) diastolic dysfunction (ejection fraction >50%, end-diastolic diameter <60 mm and increased pulmonary wedge pressure at rest and/or at peak exercise). Both atenolol and nebivolol administration was associated with a significant decrease in the resting and peak exercise heart rate and blood pressure and in LV mass, with an increase in the E/A ratio. This latter effect was greater with nebivolol. Nebivolol was associated with an increase in the peak VO(2), VO(2) at the anaerobic threshold and with a decrease in the VE/VCO(2) ratio. With regards to the hemodynamic parameters, compared to patients on atenolol, those on nebivolol showed a lower reduction in the cardiac index, a greater increase in the stroke volume index and a decline in the mean pulmonary artery pressure and pulmonary wedge pressure, both at rest and peak exercise. Thus, although the two beta-blockers have a similar antihypertensive action, nebivolol administration was associated with a greater hemodynamic improvement, compared to atenolol.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adrenergic beta-Antagonists / therapeutic use*
  • Aged
  • Antihypertensive Agents / therapeutic use*
  • Atenolol / therapeutic use*
  • Benzopyrans / therapeutic use*
  • Echocardiography
  • Ethanolamines / therapeutic use*
  • Exercise Test
  • Exercise Tolerance
  • Female
  • Heart Failure / drug therapy*
  • Heart Failure / physiopathology
  • Hemodynamics / physiology
  • Humans
  • Hypertension / drug therapy*
  • Hypertension / physiopathology
  • Male
  • Middle Aged
  • Nebivolol
  • Prospective Studies
  • Time Factors
  • Ventricular Function, Left / physiology


  • Adrenergic beta-Antagonists
  • Antihypertensive Agents
  • Benzopyrans
  • Ethanolamines
  • Nebivolol
  • Atenolol