Open AccessRealities of Newer β‐Blockers for the Management of Hypertension
Author(s) -
Manrique Camila,
Giles Thomas D.,
Ferdinand Keith C.,
Sowers James R.
Publication year - 2009
Publication title -
the journal of clinical hypertension
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.909
H-Index - 67
eISSN - 1751-7176
pISSN - 1524-6175
DOI - 10.1111/j.1751-7176.2009.00140.x
Subject(s) - nebivolol , medicine , tolerability , carvedilol , labetalol , myocardial infarction , heart failure , pharmacology , cardiology , vasodilation , adverse effect , atenolol , pharmacodynamics , isosorbide dinitrate , blood pressure , pharmacokinetics
β‐blockers are prescribed for a variety of cardiovascular conditions including hypertension, heart failure, primary treatment of myocardial infarction (MI), and secondary prevention of ischemic cardiac events. Yet they remain underprescribed in populations at increased risk for cardiovascular disease because of tolerability and safety concerns. β‐Blockers are heterogeneous with respect to pharmacokinetic and pharmacodynamic effects. “Original” agents were nonselective, blocking both β 1 ‐adrenoceptors and β 2 ‐adrenoceptors. Later, new agents were developed with selectivity for β 1 ‐adrenoceptors, and were subsequently followed by β‐blockers, which exhibit additional effects, such as vasodilation. Among newer agents, labetalol, carvedilol, and nebivolol have been approved for use in the United States. Nebivolol possesses both β 1 ‐selectivity and nitric oxide–mediated vasodilatory effects, while carvedilol has attractive effects on insulin resistance and exhibits antioxidant effects. Newer β‐blockers may overcome concerns about efficacy, adverse effects, and tolerability, while delivering cardiovascular protection.