Beta-Blockers and Hypertension: Some Questions and Answers.

Introduction: International guidelines have removed b-blockers from first-line treatment of hypertension, limiting their use to patients with compelling indications. The position of guidelines stems from the results of studies performed with the 1st and 2nd generation of b-blockers, which concluded...

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Publicado en:High Blood Pressure & Cardiovascular Prevention Vol. 30; no. 3; pp. 191 - 199
Autores principales: Fici, Francesco, Robles, Nicolas Roberto, Tengiz, Istemihan, Grassi, Guido
Formato: review tables/charts Journal Article
Publicado: Springer Nature May2023
Acceso en línea:Ver este registro en EBSCOhost
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      dt: May2023
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        10.1007/s40292-023-00576-3
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        atl: Beta-Blockers and Hypertension: Some Questions and Answers.
      aug:
        au:
          Fici, Francesco
          Robles, Nicolas Roberto
          Tengiz, Istemihan
          Grassi, Guido
        affil: Department of Cardiovascular Risk, Salamanca University, Salamanca, Spain
      sug:
        subj:
          Hypertension Drug Therapy
          Cardiovascular Diseases Drug Therapy
          Adrenergic beta-Antagonists Therapeutic Use
          Antihypertensive Agents Therapeutic Use
          Age Factors
          Blood Pressure Drug Effects
          Literature Review
      ab: Introduction: International guidelines have removed b-blockers from first-line treatment of hypertension, limiting their use to patients with compelling indications. The position of guidelines stems from the results of studies performed with the 1st and 2nd generation of b-blockers, which concluded that these drugs have lower cardiovascular protection, compared with other antihypertensive agents. Aim: The aim of our mini review is to answer to some questions about the effect of b-blockers on hypertension and cardiovascular protection and if these effects are different from those of other antihypertensive drugs, particularly in young and elderly patients. Methods: We evaluated the relevant systematic reviews and meta-analyses, which reported the effectiveness of b-blockers on blood pressure and cardiovascular outcomes, compared with placebo/no treatment and with other antihypertensive agents. Results: Beta-blockers, decreased high blood pressure with no significant difference from other common antihypertensive agents. Moreover b-blockers, compared with placebo, lowered the risk of major cardiovascular outcomes, while, compared with other drug classes, the reported results are very heterogeneous. Therefore it is difficult, globally, to find a difference between b-blockers and other drug classes. Conclusions: Rather than looking for differences in the cardiovascular protective effect between b-blockers and other antihypertensive agents, we have to consider the different pathophysiology of hypertension in young [sympathetic hyperactivity] and elderly patients [arterial stiffness, high aortic systolic pressure]. Considering these aspects, non-vasodilating b-blockers are preferred, as first-line, in young/middle aged hypertensive subjects, while vasodilating b-blockers, are most appropriate, in elderly patients, for the favourable hemodynamic profile.
      pubtype: Academic Journal
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        review
        tables/charts
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      ougenre: Article
    language: English
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