Carvedilol reduces aortic wave reflection and improves left ventricular/vascular coupling: a comparison with atenolol (CENTRAL Study)

J Clin Hypertens (Greenwich). 2011 Dec;13(12):917-24. doi: 10.1111/j.1751-7176.2011.00549.x. Epub 2011 Nov 7.


Blood pressure (BP) characteristics, such as central aortic pressure and arterial stiffness, independently predict cardiovascular events. The effects of pharmacologically dissimilar β-blockers on these properties have not been fully elucidated. Patients with essential hypertension and without significant concomitant cardiovascular disease were randomly assigned to controlled-release carvedilol, force-titrated to 80 mg (n=22), or atenolol, force-titrated to 100 mg (n=19); each was given once daily for 4 weeks. Baseline characteristics were similar. At the end of week 4, atenolol and carvedilol reduced central and brachial systolic and diastolic BP to a similar extent. Central augmentation index was increased in atenolol-treated patients but not carvedilol-treated patients (atenolol 4.47% vs carvedilol -0.68%; P=.04). Mean augmented central aortic pressure increased slightly during atenolol treatment (+1.1 mm Hg) but decreased slightly during carvedilol treatment (-1.1 mm Hg), although the difference in these changes was not statistically significant (P=.23). Pulse pressure amplification was reduced more with atenolol at week 4 (atenolol -10.7% vs carvedilol -1.8%; P=.02). Therefore, we conclude that carvedilol results in more favorable pulse pressure amplification and augmentation index by increasing arterial compliance and reducing the magnitude of wave reflection, respectively, compared with atenolol.

Publication types

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

MeSH terms

  • Adrenergic beta-Antagonists / pharmacology
  • Adrenergic beta-Antagonists / therapeutic use
  • Antihypertensive Agents / pharmacology
  • Antihypertensive Agents / therapeutic use
  • Aorta / drug effects*
  • Atenolol / pharmacology*
  • Atenolol / therapeutic use
  • Blood Pressure / drug effects*
  • Brachial Artery / drug effects
  • Carbazoles / pharmacology*
  • Carbazoles / therapeutic use
  • Carvedilol
  • Heart Ventricles / drug effects*
  • Hemodynamics / drug effects
  • Humans
  • Hypertension / drug therapy*
  • Male
  • Middle Aged
  • Propanolamines / pharmacology*
  • Propanolamines / therapeutic use
  • Statistics, Nonparametric


  • Adrenergic beta-Antagonists
  • Antihypertensive Agents
  • Carbazoles
  • Propanolamines
  • Carvedilol
  • Atenolol