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Metoprolol has a similar therapeutic effect as amlodipine on BP lowering in hypertensive patients with obstructive sleep apnea

  • Sleep Breathing Physiology and Disorders • Original Article
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Abstracts

Purpose

β-Blocker use has been controversial for a long time in the management of hypertensive patients with obstructive sleep apnea (OSA). The aim of present study was to compare the effects of metoprolol on BP lowering with amlodipine in hypertensive OSA patients.

Methods

Hypertensive subjects with OSA were randomly assigned to metoprolol and amlodipine groups, receiving 12 weeks of oral either metoprolol (47.5 mg once daily) or amlodipine (5 mg once daily) treatment. At baseline and after the 12-week treatment period, 24-h ambulatory blood pressure monitoring was performed in both groups.

Results

Both of metoprolol and amlodipine treatments significantly lowered 24-h blood pressure (BP) (from 143/88 to 132.3/81.6 mmHg; from 141.3/84.5 to 133.7/80.8 mmHg), daytime BP (from 146/90.2 to 136.4/84.6 mmHg; from 145.1/87.6 to 138.2/84.1 mmHg), and nighttime BP (from 139.1/83.9 to 125.7/76.2 mmHg; from 134.5/78.5 to 125.8/74.1 mmHg) (all P < 0.05). But there were no significant differences between the groups in BP variability (P > 0.05). Besides, metoprolol significantly reduced daytime heart rate (HR) (P < 0.05), while 24-h and nighttime HR values had no remarkable changes compared with baseline (P > 0.05).

Conclusions

Metoprolol had similar therapeutic effects on BP lowering as amlodipine and could not decrease HR during the nighttime in hypertensive patients with OSA.

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Funding

National Basic Research Program of China (973 program), National Natural Science Foundation of China, Heilongjiang Province Outstanding Youth Foundation, the Technology Research and Development Program of Heilongjiang Province, and Chang Jiang Scholar Candidates Program for Provincial Universities in Heilongjiang provided financial support in the form of Nos. 2014CB542401, 81470462, 81670297, JC201208, GA14C101, and 2013CJHB001. The sponsor had no role in the design or conduct of this research.

Author information

Author notes

  1. Jing Shi and Yue Yuan contributed equally to this work.

Authors and Affiliations

  1. Cardiovascular Department, The First Affiliated Hospital, Harbin Medical University, Harbin, People’s Republic of China

    Jing Shi, Yue Yuan, Xianzhu Deng, Yujiao Pan, Meijiao He, Guangzhong Liu, Danghui Sun, Jiayu Wang, Wennan Wang & Yue Li

  2. Institute of Metabolic Disease, Heilongjiang Academy of Medical Science, Harbin, People’s Republic of China

    Yue Li

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  1. Jing Shi
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  2. Yue Yuan
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  10. Yue Li
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Corresponding author

Correspondence to Yue Li.

Ethics declarations

The study was approved by the Ethics Committee of the First Affiliated Hospital of Harbin Medical University (ClinicalTrials.gov identifier: NCT02408172)

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Shi, J., Yuan, Y., Deng, X. et al. Metoprolol has a similar therapeutic effect as amlodipine on BP lowering in hypertensive patients with obstructive sleep apnea. Sleep Breath 23, 227–233 (2019). https://doi.org/10.1007/s11325-018-1688-5

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  • DOI: https://doi.org/10.1007/s11325-018-1688-5

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