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Objective: To evaluate ventricular-arterial coupling in hypertensive patients after therapy with a beta-blocker and its fixed dose combination (FDC) with amlodipine.

Design and method: 28 patients (age 53, 95+ 7, 2, 20 males, BP 148, 7+ 13, 4/96, 6+ 14, 1 mmHg, HR 83, 2+ 10, 1 bpm) with untreated uncomplicated hypertension underwent simultaneous EchoCG and blood pressure (BP) acquisition at baseline, after 4 weeks of bisoprolol 5-10 mg monotherapy and after 8 weeks after switching to FDC bisoprolol 5-10/amlodipine 5-10 mg. Doses were titrated to reach BP< 140/90 mmHg. Arterial elastance (Ea) and LV elastance (Ees) at rest were calculated as end-systolic pressure (ESP)/stroke volume (SV) and ESP/end-systolic volume (ESV). Ventricular-arterial coupling (VAC) was assessed as Ea/Ees. Mechanical efficiency of left ventricle (ELV) and peripheral arterial resistance (PAR) were evaluated also. p< 0, 05 was considered significant. Results: After monotherapy with bisoprolol BP was 146, 1+ 15, 3/85, 3+ 11, 3 mmHg (p> 0, 05 vs baseline), HR 59, 8+ 7, 7 (p< 0, 05 vs baseline), after FDC 132, 1+ 11, 3/76, 23+ 11, 1 mmHg and 64, 54+ 7, 0 bpm, respectively (all p< 0, 05 vs baseline). Bisoprolol decreased Ees from 4, 45+ 1, 9 to 3, 67+ 0, 98 (p< 0, 05) whereas Ea, PAR did not change significantly. Ea/Ees increased significantly from 0, 47+ 0, 16 to 0, 55+ 0, 14 (p< 0, 05). Switching to bisoprolol/amlodipine FDC resulted in decrease of Ea from 1, 88+ 0, 39 at baseline and from 1, 92+ 0, 38 after bisoprolol monotherapy, PAR from 137, 1+ 35, 3 at baseline and from 128, 9+ 36, respectively to 105, 6+ 28. Ees did not change from that on bisoprolol …