Journal
PROGRESS IN CARDIOVASCULAR DISEASES
Volume 59, Issue 3, Pages 247-252Publisher
W B SAUNDERS CO-ELSEVIER INC
DOI: 10.1016/j.pcad.2016.10.005
Keywords
beta-Adrenergic blockade; beta-Blockers; Hypertension; Adrenergic blockade; Sympathetic blockade
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Beta-adrenergic receptor blockers (beta-blockers) are an appropriate treatment for patients having systemic hypertension (HTN) who have concomitant ischemic heart disease (IHD), heart failure, obstructive cardiomyopathy, aortic dissection or certain cardiac arrhythmias. beta-Blockers can be used in combination with other antiHTN drugs to achieve maximal blood pressure control. Labetalol can be used in HTN emergencies and urgencies. beta-Blockers may be useful in HTN patients having a hyperkinetic circulation (palpitations, tachycardia, HTN, and anxiety), migraine headache, and essential tremor. beta-Blockers are highly heterogeneous with respect to various pharmacologic properties: degree of intrinsic sympathomimetic activity, membrane stabilizing activity, beta(1) selectivity, alpha(1) - aradrenergic blocking effects, tissue solubility, routes of systemic elimination, potencies and duration of action, and specific properties may be important in the selection of a drug for clinical use. beta(-)Blocker usage to reduce perioperative myocardial ischemia and cardiovascular (CV) complications may not benefit as many patients as was once hoped, and may actually cause harm in some individuals. Currently the best evidence supports perioperative beta-blocker use in two patient groups: patients undergoing vascular surgery with known IHD or multiple risk factors for it, and for those patients already receiving beta-blockers for known CV conditions. (C) 2016 Elsevier Inc. All rights reserved.
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