Optimal use of beta-blockers in high-risk hypertension: a guide to dosing equivalence

Vasc Health Risk Manag. 2010 Jun 1:6:363-72. doi: 10.2147/vhrm.s6668.

Abstract

Hypertension is the number one diagnosis made by primary care physicians, placing them in a unique position to prescribe the antihypertensive agent best suited to the individual patient. In individuals with diabetes mellitus, blood pressure (BP) levels>130/80 mmHg confer an even higher risk for cardiovascular and renal disease, and these patients will benefit from aggressive antihypertensive treatment using a combination of agents. beta-blockers are playing an increasingly important role in the management of hypertension in high-risk patients. beta-blockers are a heterogeneous class of agents, and this review presents the differences between beta-blockers and provides evidence-based protocols to assist in understanding dose equivalence in the selection of an optimal regimen in patients with complex needs. The clinical benefits provided by beta-blockers are only effective if patients adhere to medication treatment long term. beta-blockers with proven efficacy, once-daily dosing, and lower side effect profiles may become instrumental in the treatment of hypertensive diabetic and nondiabetic patients.

Keywords: antihypertensive; atenolol; blood pressure; carvedilol; labetalol; metoprolol; nebivolol.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Adrenergic beta-Antagonists / administration & dosage*
  • Adrenergic beta-Antagonists / adverse effects
  • Antihypertensive Agents / administration & dosage*
  • Antihypertensive Agents / adverse effects
  • Blood Pressure / drug effects*
  • Drug Dosage Calculations
  • Evidence-Based Medicine
  • Humans
  • Hypertension / complications
  • Hypertension / drug therapy*
  • Hypertension / physiopathology
  • Medication Adherence
  • Patient Selection
  • Practice Guidelines as Topic
  • Risk Assessment
  • Risk Factors
  • Treatment Outcome

Substances

  • Adrenergic beta-Antagonists
  • Antihypertensive Agents