How useful are β-blockers in cardiovascular disease?
1Department of Medicine, Division of Cardiology, St. Luke's-Roosevelt Hospital, Columbia University, New York, New York, USA
Anatol J Cardiol 2006; 6(4): 358-363 PubMed ID: 17162285
Full Text PDF

Abstract

Recent studies have shown that β-blockers in patients with hypertension is associated with an increased risk of cardiovascular events, in particular stroke, leading to headlines speculating the end of theβ-blocker era. The objective of this review is to critically examine the use- fulness of β-blockers in cardiovascular diseases. We reviewed the currently available evidence for the usefulness of β-blockers in pati- ents with hypertension and also assessed the efficacy of its use for other indications, like, chronic heart failure, stable angina, myocardi- al infarction, arrhythmias etc. The review of the currently available literature shows that for patients with uncomplicated hypertension, the- re is paucity of data or absence of evidence to support use of β-blockers as monotherapy or as first line agent. Given the risk of stroke and numerous unacceptable adverse effects, the risk benefit ratio for β-blockers is not acceptable for this indication. However, β-bloc- kers are very efficacious agents for the treatment of heart failure, certain types of arrhythmia, and post myocardial infarction. The various guideline committees should seriously reconsider their decision about their endorsement of β-blockers as first line therapy for uncompli- cated hypertension. However, this is applicable for hypertension and β-blockers continue to be efficacious for other indications.