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.
McGill
Janet B
JB
Department of Medicine, Washington University School of Medicine, St. Louis, Missouri 63110, USA. jmcgill@im.wustl.edu
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