College of Medicine, Medical University of South Carolina and Ralph H Johnson VA Medical Center, Charleston, South Carolina 29425-0950, USA.
Am J Med. 2010 Jul;123(7 Suppl 1):S9-15. doi: 10.1016/j.amjmed.2010.04.013.
Beta-blockers have played a key role in the management of hypertension-related cardiovascular disease for decades, and continue to be recommended as a mainstay of therapy in national guidelines statements. Recent data have shown less optimal reductions in total mortality, CVD mortality, and CVD events with beta-blockers compared with renin-angiotensin system-blocking agents or calcium channel blockers. The beta-blocker class, however, spans a wide range of agents, and the growing concern about the risk-benefit profile of beta-blockers should not be generalized to later-generation vasodilating beta-blockers such as carvedilol and nebivolol. A growing database from hypertension studies confirms the clinical efficacy and safety of vasodilating beta-blockers, and outcome studies indicate that these agents can play an important role in global CVD reduction in patients with hypertensive or ischemic heart failure.
β受体阻滞剂在与高血压相关的心血管疾病的管理中发挥了关键作用，数十年来一直被推荐作为国家指南声明中治疗的主要药物。最近的数据显示，与肾素-血管紧张素系统阻断剂或钙通道阻滞剂相比，β受体阻滞剂在降低总死亡率、心血管死亡率和心血管事件方面的效果不太理想。然而，β受体阻滞剂类药物涵盖了广泛的药物，对于β受体阻滞剂的风险-收益状况日益增加的担忧不应该被推广到卡维地洛和奈必洛尔等新一代的血管扩张β受体阻滞剂。来自高血压研究的不断增长的数据库证实了血管扩张β受体阻滞剂的临床疗效和安全性，并且结果研究表明，这些药物在降低高血压或缺血性心力衰竭患者的全球心血管疾病风险方面可以发挥重要作用。
