The role of beta-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 beta beta-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 beta beta-blockers in current clinical practice and the benefits of beta beta-blockade in selected patient populations. In addition to their use as a potential first-line therapy in uncomplicated hypertension, beta beta-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 beta beta-blockers offer is the additional protective effects in patients with prior cardiovascular events. Some of the disadvantages attributed to beta beta-blockers appear more related to the older drugs in this class and further appraisal of the efficacy and safety profile of newer beta beta-blockers will lend support to the current guideline recommendations in Asian countries and encourage increased appropriate use of beta beta-blockade in current clinical practice within Asia.