title: Betablockers in combination with other antihypertensives.
abstract: Betablockers (BB) have been recognized as effective antihypertensive agents. Recent meta analysis of various hypertension trials have brought to light the inferiority of BB compared to other antihypertensives as a first line monotherapy agent. Combination of BB with dihydropyridine Calcium Channel Blocker (CCB) has been especially effective in smooth control of BP. Combination of diuretics with BB should be avoided in patients with dyslipidaemia and in those prone to develop diabetes. BB can be combined with vasodilators and alpha blockers with good therapeutic benefit. BB with angiotensin converting enzyme inhibitors/angiotensin receptor blockers (ACEI/ARB) is not an ideal combination as both the drugs act in the renin-angiotensin system. However, in hypertension with certain specific clinical situation this combination is useful. BB as a monotherapy agent is being less preferred in the treatment of hypertension based on recent evidence while in suitable combination it is a valuable antihypertensive.
authors.affiliation: Pushpagiri Heart Institute, Thiruvalla, Kerala, India. phitvla@gmail.com
authors.forename: R J
authors.initials: RJ
authors.lastname: Manjuran
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000008:administration & dosage* / Q000009:adverse effects / Q000145:classification / Q000494:pharmacology / Q000627:therapeutic use; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000008:administration & dosage; D002121:Calcium Channel Blockers / Q000008:administration & dosage* / Q000009:adverse effects; D004095:Dihydropyridines / Q000008:administration & dosage / Q000009:adverse effects; D004232:Diuretics / Q000008:administration & dosage* / Q000009:adverse effects; D004359:Drug Therapy, Combination; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000188:drug therapy*; D015201:Meta-Analysis as Topic; D016032:Randomized Controlled Trials as Topic; D013610:Tachycardia / Q000139:chemically induced; D014665:Vasodilator Agents / Q000008:administration & dosage* / Q000009:adverse effects
chemical_list: D000319:Adrenergic beta-Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D002121:Calcium Channel Blockers; D004095:Dihydropyridines; D004232:Diuretics; D014665:Vasodilator Agents; C038806:1,4-dihydropyridine