Elsevier

International Journal of Cardiology

Volume 224, 1 December 2016, Pages 145-148
International Journal of Cardiology

Review
Effect of ivabradine on central aortic blood pressure in patients with stable coronary artery disease: What do we know?

https://doi.org/10.1016/j.ijcard.2016.09.054Get rights and content

Highlights

  • Central blood pressure has been linked with cardiovascular protection.

  • Ivabradine reduces heart rate without other hemodynamic effects.

  • Ivabradine prolongs diastolic phase without a significant impact on ejection time.

  • Ivabradine is unlikely to increase CBP by increasing the reflected wave.

Abstract

Treatment of hypertensive patients with beta-blockers decreases central blood pressure (CBP) less than other antihypertensive drugs, which is believed to account for their lesser cardiovascular protection in this setting. Some authors have suggested that decreasing heart rate (HR) with beta-blockers would increase CBP. In contrast to beta-blockers, the anti-anginal agent ivabradine reduces HR without other hemodynamic effects, and represents an attractive tool for exploring the direct relationship between HR and CBP. Here, we review the available clinical data assessing the effect of selective HR reduction with ivabradine on CBP in patients with stable coronary artery disease (CAD). We collected data from five studies which report either increase, decrease, or neutral effects of ivabradine on CBP. Further studies are needed to clarify the exact role of ivabradine on CBP. However, as supported by its pharmacodynamic effect in patients with stable CAD, available evidence to date suggests that ivabradine does not negatively impact CBP when associated with beta-blocker. HR reduction with both beta-blockers and ivabradine remains well-established treatments for the symptomatic treatment of angina patients.

Section snippets

Conflict of interest

Y.L. has received speaker fees, research or travel grants from Servier (manufacturer of ivabradine). C.V. was an investigator in a clinical trial sponsored by Servier investigating the effect of ivabradine on central blood pressure, but did not receive any personal fees for this activity.

Ethics

The authors of this manuscript have certified that they comply with the Principles of Ethical Publishing in the International Journal of Cardiology.

Informed consent was obtained from each patient and the study protocols conform to the ethical guidelines of the 1975 Declaration of Helsinki as reflected in a priori approval by institution's human research committees.

Acknowledgments

We thank Julie Salzmann, PhD, who provided the medical writing assistance on behalf of Servier, France.

References (11)

There are more references available in the full text version of this article.

Cited by (0)

View full text