title: Clinical use of beta blockers in hypertension.
abstract: Recent work on the use of beta blockade in the treatment of mild hypertension is reviewed. It is clear from these studies that this form of antihypertensive therapy can exercise a protective influence on cerebrovascular events and on fatal and nonfatal myocardial infarction. In particular, there is evidence of reduced rate of reinfarction when beta-blocking agents are started soon after the first event. The comparative efficacy and side effects profile of the various clinically available beta blockers are discussed, as differences between these are now becoming more apparent. In particular, the degree of water or lipid solubility may determine which will penetrate into brain tissue with resultant central effect; the more water soluble, the less likely this is to occur. It is also important that those which are not metabolised by the liver can be more easily titrated as they do not require large changes in dosage; some may be given once daily. The use of beta blockade in the presence of airway resistance is strongly contraindicated but, if it has to be used, this should be started in hospital with a cardioselective agent.
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000009:adverse effects / Q000627:therapeutic use*; D001581:Benzothiadiazines; D004232:Diuretics; D004359:Drug Therapy, Combination; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D049993:Sodium Chloride Symporter Inhibitors / Q000627:therapeutic use; D013375:Substance Withdrawal Syndrome / Q000503:physiopathology
chemical_list: D000319:Adrenergic beta-Antagonists; D001581:Benzothiadiazines; D004232:Diuretics; D049993:Sodium Chloride Symporter Inhibitors