Optimal use of beta-blockers in high-risk hypertension: a guide to dosing equivalence.
Hypertension is the number one diagnosis made by primary care physicians, placing them in a unique position to prescribe the antihypertensive agent best suited to the individual patient. In individuals with diabetes mellitus, blood pressure (BP) levels>130/80 mmHg confer an even higher risk for cardiovascular and renal disease, and these patients will benefit from aggressive antihypertensive treatment using a combination of agents. beta-blockers are playing an increasingly important role in the management of hypertension in high-risk patients. beta-blockers are a heterogeneous class of agents, and this review presents the differences between beta-blockers and provides evidence-based protocols to assist in understanding dose equivalence in the selection of an optimal regimen in patients with complex needs. The clinical benefits provided by beta-blockers are only effective if patients adhere to medication treatment long term. beta-blockers with proven efficacy, once-daily dosing, and lower side effect profiles may become instrumental in the treatment of hypertensive diabetic and nondiabetic patients.
Department of Medicine, Washington University School of Medicine, St. Louis, Missouri 63110, USA. jmcgill@im.wustl.edu
Janet B
JB
McGill
D000319:Adrenergic beta-Antagonists / Q000008:administration & dosage* / Q000009:adverse effects; D000959:Antihypertensive Agents / Q000008:administration & dosage* / Q000009:adverse effects; D001794:Blood Pressure / Q000187:drug effects*; D054796:Drug Dosage Calculations; D019317:Evidence-Based Medicine; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D055118:Medication Adherence; D018579:Patient Selection; D017410:Practice Guidelines as Topic; D018570:Risk Assessment; D012307:Risk Factors; D016896:Treatment Outcome
D000319:Adrenergic beta-Antagonists; D000959:Antihypertensive Agents