One size does not fit all: the role of vasodilating beta-blockers in controlling hypertension as a means of reducing cardiovascular and stroke risk.
Beta-blockers have played a key role in the management of hypertension-related cardiovascular disease for decades, and continue to be recommended as a mainstay of therapy in national guidelines statements. Recent data have shown less optimal reductions in total mortality, CVD mortality, and CVD events with beta-blockers compared with renin-angiotensin system-blocking agents or calcium channel blockers. The beta-blocker class, however, spans a wide range of agents, and the growing concern about the risk-benefit profile of beta-blockers should not be generalized to later-generation vasodilating beta-blockers such as carvedilol and nebivolol. A growing database from hypertension studies confirms the clinical efficacy and safety of vasodilating beta-blockers, and outcome studies indicate that these agents can play an important role in global CVD reduction in patients with hypertensive or ischemic heart failure.
Basile
Jan N
JN
College of Medicine, Medical University of South Carolina and Ralph H Johnson VA Medical Center, Charleston, South Carolina 29425-0950, USA. basilejn@musc.edu
D000319:Adrenergic beta-Antagonists / Q000494:pharmacology / Q000627:therapeutic use*; D001578:Benzopyrans / Q000627:therapeutic use; D004983:Ethanolamines / Q000627:therapeutic use; D006801:Humans; D006973:Hypertension / Q000503:physiopathology / Q000517:prevention & control*; D000068577:Nebivolol; D018570:Risk Assessment; D020521:Stroke / Q000503:physiopathology / Q000517:prevention & control*; D014665:Vasodilator Agents / Q000494:pharmacology / Q000627:therapeutic use*
D000319:Adrenergic beta-Antagonists; D001578:Benzopyrans; D004983:Ethanolamines; D014665:Vasodilator Agents; D000068577:Nebivolol