Background. While all antihypertensive medications lower blood pressure, hemodynamic properties of various classes of antihypertensive medications may differ. Objective. To perform a meta-analysis to compare the hemodynamic properties of different classes of antihypertensive medications. Methods. Studies involving the treatment of hypertension using the effect of ACEIs, β-blockers, CCBs and thiazide diuretics on plasma volume (PV), cardiac output (CO) or stroke volume (SV) were searched using online databases prior to May 2011. Studies had to be written in the English language, studying human subjects with a single pharmacological agent (monotherapy), and with a minimum duration of 4 weeks. Results. Seventy-five (75) studies that enrolled a total of 1522 subjects were included. All four antihypertensive classes lowered blood pressure. β-blockers decreased heart rate; the other classes had no effect upon heart rate. ACEIs increased PV; the other classes had no effect upon PV. β-blockers and thiazide diuretics decreased CO while ACEIs and CCBs had no effect upon CO. β-blockers and CCBs increased SV, thiazide diuretics decreased SV, and ACEIs did not change SV. Conclusion. In the treatment of uncomplicated hypertension, the various classes of antihypertensive medications differ from each other in terms of their non-blood pressure lowering hemodynamic properties. 1. Introduction While all antihypertensive medications lower blood pressure, the non-blood-pressure-lowering hemodynamic properties of the various classes of antihypertensive medications may differ. Numerous studies documenting the effects of different antihypertensive medications upon heart rate (HR), plasma volume (PV), cardiac output (CO), and stroke volume (SV) have been published, but the sample sizes of most of these studies have been small, typically less than 20 subjects each. Differences in hemodynamic properties that distinguish one class of antihypertensive medication from another might not be evident in studies with such small samples. Furthermore, if there are differences in hemodynamic properties among the different classes of antihypertensive drugs, such differences might help clinicians customize the selection of drugs for individual patients. We performed this meta-analysis in order to clarify and compare the hemodynamic properties of four different classes of antihypertensive medications: angiotensin converting enzyme inhibitors (ACEIs), -adrenergic receptor antagonists ( -blockers), calcium channel blockers (CCBs), and thiazide diuretics. 2. Methods 2.1. Search Strategy and
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