Document Detail


Current role of beta-blockers in the treatment of hypertension.
MedLine Citation:
PMID:  20426702     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
IMPORTANCE OF THE FIELD: It is important to know which patients with hypertension will benefit from beta-blocker therapy and which beta-blockers should be used in the treatment of hypertension to reduce cardiovascular events and mortality.
AREAS COVERED IN THIS REVIEW: Studies between 1981 and 2009 using a Medline search are reported. Beta-blockers should be used to treat hypertension in patients with previous myocardial infarction, acute coronary syndromes, angina pectoris, congestive heart failure, ventricular arrhythmias, supraventricular tachyarrhythmias, diabetes mellitus, after coronary artery bypass graft surgery, and in patients who are pregnant, have thyrotoxicosis, glaucoma, migraine, essential tremor, perioperative hypertension, or an excessive blood pressure response after exercise.
WHAT THE READER WILL GAIN: The use of beta-blockers as first-line therapy in patients with primary hypertension has been controversial. However, the 2009 guidelines of the European Society of Hypertension state that large-scale meta-analyses of available data confirm that diuretics, beta-blockers, angiotensin-converting enzyme inhibitors, angiotensin receptor blockers and calcium channel blockers do not significantly differ in their ability to lower blood pressure and to exert cardiovascular protection both in elderly and in younger patients.
TAKE HOME MESSAGE: The key message of this paper is that atenolol should not be used as an antihypertensive drug and that the degree of reduction of mortality, myocardial infarction, stroke and congestive heart failure by antihypertensive therapy is dependent on the degree of lowering of aortic blood pressure. Newer vasodilator beta-blockers such as carvedilol and nebivolol may be more effective in reducing cardiovascular events than traditional beta-blockers, but this needs to be investigated by controlled clinical trials.
Authors:
Wilbert S Aronow
Publication Detail:
Type:  Journal Article     Date:  2010-04-28
Journal Detail:
Title:  Expert opinion on pharmacotherapy     Volume:  11     ISSN:  1744-7666     ISO Abbreviation:  Expert Opin Pharmacother     Publication Date:  2010 Nov 
Date Detail:
Created Date:  2010-10-27     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100897346     Medline TA:  Expert Opin Pharmacother     Country:  England    
Other Details:
Languages:  eng     Pagination:  2599-607     Citation Subset:  IM    
Affiliation:
New York Medical College, Cardiology Division, Department of Medicine, Valhalla, NY 10595, USA. wsaronow@aol.com
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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