title: The role of β-blockers in the management of hypertension: an Asian perspective.
abstract: Following publication of the National Institute of Clinical Excellence (NICE) Guidelines in 2006, the use of β-blockers as first-line therapy in hypertension has been somewhat controversial. However, a recent reappraisal of the European Society of Hypertension guidelines highlights that these agents exhibit similar BP lowering efficacy to other classes of agents, prompting a re-examination of the utility of these agents in various patient populations. The authors felt that it is important to address this controversy and provide an Asian perspective on the place of β-blockers in current clinical practice and the benefits of β-blockade in selected patient populations. In addition to their use as a potential first-line therapy in uncomplicated hypertension, β-blockers have a particular role in patients with hypertension and comorbidities such as heart failure or coronary artery disease, including those who had a myocardial infarction. One advantage which β-blockers offer is the additional protective effects in patients with prior cardiovascular events. Some of the disadvantages attributed to β-blockers appear more related to the older drugs in this class and further appraisal of the efficacy and safety profile of newer β-blockers will lend support to the current guideline recommendations in Asian countries and encourage increased appropriate use of β-blockade in current clinical practice within Asia.
authors.affiliation: Department of Medicine and Therapeutics; Division of Clinical Pharmacology, The Chinese University of Hong Kong, Hong Kong SAR. btomlinson@cuhk.edu.hk
authors.forename: B
authors.initials: B
authors.lastname: Tomlinson
authors.forename: J J
authors.initials: JJ
authors.lastname: Dalal
authors.forename: J
authors.initials: J
authors.lastname: Huang
authors.forename: L P
authors.initials: LP
authors.lastname: Low
authors.forename: C G
authors.initials: CG
authors.lastname: Park
authors.forename: A R
authors.initials: AR
authors.lastname: Rahman
authors.forename: E B
authors.initials: EB
authors.lastname: Reyes
authors.forename: A A
authors.initials: AA
authors.lastname: Soenarta
authors.forename: A
authors.initials: A
authors.lastname: Heagerty
authors.forename: F
authors.initials: F
authors.lastname: Follath
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000009:adverse effects* / Q000627:therapeutic use*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001210:Asia, Southeastern / Q000453:epidemiology; D003324:Coronary Artery Disease / Q000188:drug therapy / Q000401:mortality; D005260:Female; D006333:Heart Failure / Q000188:drug therapy / Q000401:mortality; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000188:drug therapy / Q000401:mortality; D017410:Practice Guidelines as Topic
chemical_list: D000319:Adrenergic beta-Antagonists