β‐Blockers in Hypertension: A Reassessment of the Benefit of Combined α‐/β‐Blockade

β‐Blockers have a long history of use in patients with high blood pressure, either alone or in combination with other classes of antihypertensive agents. Although β‐blockers can lower blood pressure effectively, they have not been convincingly shown to reduce the likelihood of some cardiovascular complications from hypertension, and their utility for this purpose has been critically questioned of late. This growing distrust of β‐blocker therapy, however, is misguided. Negative sentiments about one drug in a class, as has been the case for atenolol, often become unfairly disparaging of all drugs in a class. In the process of such lumping, the heterogeneity of the various compounds making up a drug class is often neglected. Such is the case for combined α‐/β‐blockade, which is to be distinguished from β‐blockade alone because of differences in hemodynamic and metabolic effects. This should prompt a reappraisal of the role of selected agents, such as the combined α‐/β‐blocker carvedilol, in the long‐term treatment of hypertension.