Abstract
Arterial hypertension is a significant cause of end-stage renal failure; effective treatment of hypertensive patients reduces the rate of progression of this disorder. β-Blockers, particularly nonselective agents, are associated with deterioration of renal function in patients with chronic renal failure. Previous studies on the interaction of the β1-selective adrenergic antagonist bisoprolol with kidney function have been performed only acutely and over the short term. This study was designed to evaluate the antihypertensive efficacy and effects on renal hemodynamics and function of bisoprolol during medium-term (6 mo) treatment of patients with mild to moderate essential hypertension. After a 2-wk run-in period on placebo, 87 consecutive hypertensive patients (46 men, 41 women) according to ESH-ESC (European Society of Hypertension/European Society of Cardiology) guidelines, aged from 27 to 64 y (mean age, 50±11 y), without renal or cardiovascular disease, were enrolled and assigned to treatment with bisoprolol 5 mg once daily for 6 mo. At recruitment and at 6 mo after treatment, renal function was assessed and renal hemodynamics evaluated in all patients through radioisotope studies. The mediumterm effects of bisoprolol included a significant reduction in blood pressure and heart rate (P< .001) without significant adverse drug reactions. Moreover, bisoprolol produced no alteration in renal function or hemodynamics, or in cardiac output. Data presented here indicate that bisoprolol 5 mg given once daily to treat patients with mild to moderate essential hypertension is effective and safe for treatment and for preservation of renal performance when given on a medium-term basis.
Similar content being viewed by others
References
Lindeman RD, Tobin JD, Shock NW. Association between blood pressure and the rate of decline in renal function with age.Kidney Int. 1984;26:861–868.
London GM, Safar ME, Sassard JE, Levenson JA, Simon AC. Renal and systemic haemodynamics in sustained essential hypertension.Hypertension. 1984;6:743–754.
Marin R, Gorostidi M, Fernandez-Vega F, Alvarez-Navascues R. Systemic and glomerular hypertension and progression of chronic renal disease: the dilemma of nephrosclerosis.Kidney Int Suppl. 2005;99:S52-S56.
Brenner BM. Nephron adaptation to renal injury or ablation.Am J Physiol. 1985;249:F324-F327.
Dworkin LD, Feiner HD, Randazzo J. Glomerular injury in uninephrectomized spontaneously hypertensive rats: a consequence of glomerular capillary hypertension.J Clin Invest. 1986;77: 797–809.
Ljungman S, Wikstrand J, Hartford M, Aurell M, Lindstedt G, Berglund G. Effects of long-term antihypertensive treatment and aging on renal function and albumin excretion in primary hypertension.Am J Hypertens. 1993;6:554–563.
Cruickshank JM. Are we understanding beta-blockers?Int J Cardiol. 2007;120:10–27.
Waal-Manning HJ. Atenolol and three nonselective beta-blockers in hypertension.Pharmacol Ther. 1979;25:8–18.
Manning HJ, Bolli P. Atenolol versus placebo in mild hypertension: renal metabolic and stress antipressor effects.Br J Clin Pharmacol. 1980;9:553–560.
Warren DJ, Swainson CP, Wright N. Deterioration in renal function after beta-blockade in patients with chronic renal failure and hypertension.Br Med J. 1974;2:193–194.
Snell A, Wallace M. Beta blockade in the presence of renal disease and hypertension.Br Med J. 1974;2:672.
Swainson CP, Winney RJ. Effect of beta-blockade in chronic renal failure.Br Med J. 1976;1:459.
Johns TE, Lopez LM. Bisoprolol: is this just another beta-blocker for hypertension or angina?Ann Pharmacother. 1995;29:403–414.
Czuriga I, Riecansky I, Bodnar J, et al. Comparison of the new cardioselective beta-blocker nebivolol with bisoprolol in hypertension: the Nebivolol, Bisoprolol Multicenter Study (NEBIS).Cardiovasc Drugs Ther. 2003;17:257–263.
ESH/ESC Guidelines Committee. 2003 European Society of Hypertension-European Society of Cardiology guidelines for the management of arterial hypertension.J Hypertens. 2003, 21: 1011–1053.
Schlegel JU, Haway SA. Individual renal plasma flow determination in 2 minutes.J Urol. 1976; 111:282–288.
Gates GE. Glomerular filtration rate: estimation from fractional renal accumulation of 99m-Tc-DTPA.Am J Radiol. 1981;138:565–570.
Schiller NB, Shah PM, Crawford M, et al. Recommendations for quantification of left ventricle by two dimensional echocardiography.J Am Soc Echocardiogr. 1989;2:358–367.
Bakris GL, Hart P, Ritz E. Beta-blockers in the management of chronic kidney disease.Kidney Int. 2006;70:1905–1913.
Ruilope LM, Alcazar JM, Hernandez E, Moreno F, Martinez MA, Rodicio J. Does an adequate control of blood pressure protect the kidney in essential hypertension?J Hypertens. 1990;8:525–531.
Parving HH, Andersen AR, Smith UM, Home L, Mathiesen ES, Svendsen PA. Effect of antihypertensive treatment on kidney function and diabetic nephropathy.BMJ. 1987;294:1443–1447.
Baker JG. The selectivity of β-adrenoceptor antagonists at the human β1, β2 and β3 adrenoceptors.Br J Pharmacol. 2005;144:317–322.
Oral I, Vareka I, Marek D. The effect of a single dose of bisoprolol on changes in blood pressure and hemodynamic indicators in patients with mild hypertension.Vnitr Lek. 1992;38:980–985.
Brazy PC, Stead WW, Fitzwilliam JF. Progression of renal insufficiency: role of blood pressure.Kidney Int. 1989;35:670–674.
Scaglione R, Ganguzza A, Corrao S, et al. Effect of cilazapril on renal haemodynamics and function in hypertensive patients: a randomised controlled study versus hydrochlorothiazide.Blood Press. 1995;4:363–368.
Scaglione R, Indovina A, Parrinello G, et al. Antihypertensive efficacy and effects of nitrendipine on cardiac and renal hemodynamics in mild to moderate hypertensive patients: randomized controlled trial versus hydrochlorothiazide.Cardiovasc Drugs Ther. 1992;6:141–146.
Paterna S, Parrinello G, Scaglione R, et al. Effect of long-term losartan administration on renal haemodynamics and function in hypertensive patients.Cardiovasc Drugs Ther. 2000;14:529–532.
Licata G, Scaglione R, Guillet C, et al. Double-blind controlled study of rilmenidine versus hydrochlorothiazide in mild hypertension: clinical and renal haemodynamic evaluation.J Hum Hypertens. 1992;6:140–146.
Licata G, Scaglione R, Ganguzza A, et al. Effects of amlodipine on renal haemodynamics in mild to moderate hypertensive patients: a randomized controlled study versus placebo.Eur J Clin Pharmacol. 1993;45:307–311.
Uehara Y, Takada S, Hirawa N, et al. Vasoconstrictor and renal protection induced by beta 1-selective adrenoceptor antagonist bisoprolol.J Cardiovasc Pharmacol. 1994;23:897–906.
Gluck Z, Reubi FC. Acute changes in renal function induced by bisoprolol, a new cardioselective beta-blocking agent.Eur J Clin Pharmacol. 1986;31:107–111.
Leeman M, van de Borne P, Collart F, et al. Bisoprolol and atenolol in essential hypertension: effects on systemic and renal hemodynamics and on ambulatory blood pressure.J Cardiovasc Pharmacol. 1993;22:785–791.
Ots M, Mackenzie HS, Troy JL, Rennke HG, Brenner BM. Effects of combination therapy with enalapril and losartan on the rate of progression of renal injury in rats with 5/6 renal mass ablation.J Am Soc Nephrol. 1998;9:224–230.
Aunapuu M, Pechter U, Arend A, Suuroja T, Ots M. Ultrastructural changes in the remnant kidney (after 5/6 nephrectomy) glomerulus after losartan and atenolol treatment.Medicina (Kaunas). 2003;39:975–979.
Loutzenhiser R, Griffin K, Williamson G, Bidani A. Renal autoregulation: new perspectives regarding the protective and regulatory roles of the underlying mechanisms.Am J Physiol Regul Integr Comp Physiol. 2006;290:R1153-R1167.
Kvam FI, Ofstad J, Iversen BM. Effects of antihypertensive drug on autoregulation of RBF and glomerular capillary pressure in SHR.Am J Physiol. 1998;275:F576-F584.
Iversen BM, Sekse I, Ofstad J. Resetting of renal blood flow autoregulation in spontaneously hypertensive rats.Am J Physiol. 1987;252:F480-F486.
Iversen BM, Kvam FI, Matre K, Ofstad J. Resetting of renal blood autoregulation during acute blood pressure reduction in hypertensive rats.Am J Physiol Renal Physiol. 1998;275:576–584.
Willenheimer R, van Veldhuisen DJ, Silke B, et al, CIBIS III Investigators. Effect on survival and hospitalization of initiating treatment for chronic heart failure with bisoprolol followed by enalapril, as compared with the opposite sequence: results of the Randomized Cardiac Insufficiency Bisoprolol Study (CIBIS III).Circulation. 2005;112:2426–2435.
Author information
Authors and Affiliations
Corresponding author
Additional information
An erratum to this article can be found online at http://dx.doi.org/10.1007/s12325-008-0046-6.
Rights and permissions
About this article
Cite this article
Paterna, S., Parrinello, G., Di Pasquale, P. et al. Medium-term effects of bisoprolol administration on renal hemodynamics and function in mild to moderate essential hypertension. Adv Therapy 24, 1260–1270 (2007). https://doi.org/10.1007/BF02877772
Issue Date:
DOI: https://doi.org/10.1007/BF02877772