The role of vasodilating beta-blockers in patients with complicated hypertension: focus on nebivolol.
Despite their proven mortality and morbidity outcomes benefits, beta-blockers remain substantially underused in patients with cardiac conditions. Reluctance to prescribe beta-blockers may be owing to concerns about tolerability with the traditional drugs in this class. Beta-blockers with vasodilatory properties, such as carvedilol and nebivolol, may overcome the tolerability and metabolic issues associated with traditional beta-blockers. Because endothelial dysfunction, the pathophysiologic hallmark of hypertension, may be heightened in populations with difficult-to-treat hypertension (e.g., elderly patients, African American patients), a vasodilating beta-blocker may be a particularly appropriate choice for these patient groups.
Giles
Thomas D
TD
Department of Medicine, Tulane University School of Medicine, New Orleans, Louisiana, USA. tgiles4@cox.net
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use*; D001741:Black or African American; D000368:Aged; D000369:Aged, 80 and over; D001578:Benzopyrans / Q000627:therapeutic use*; D004983:Ethanolamines / Q000627:therapeutic use*; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000453:epidemiology*; D008875:Middle Aged; D000068577:Nebivolol; D012307:Risk Factors; D014665:Vasodilator Agents / Q000627:therapeutic use*
D000319:Adrenergic beta-Antagonists; D001578:Benzopyrans; D004983:Ethanolamines; D014665:Vasodilator Agents; D000068577:Nebivolol