Lardizabal Joel A, Deedwania Prakash C
Division of Cardiology, University of California in San Francisco School of Medicine, Fresno Medical Education Program, Fresno, CA, USA.
Indian Heart J. 2010 Mar-Apr;62(2):111-7.
Beta adrenergic blockers have had a long history as frontline agents in hypertension therapy. They are the mainstay of treatment in ischemic heart disease, heart failure, high risk coronary artery disease and arrhythmias, as their importance in these compelling indications are well-established. However, the efficacy and relevance of beta blockers in the treatment of uncomplicated hypertension have been questioned because the traditional agents were deemed not atpar with drugs from other classes in terms of cardiovascular outcomes. Although atenolol and other traditional agent s have lost favor, the other cardioselective agents have been shown to be at least as efficacious in hypertension as the other classes of drugs. Their use in hypertension therapy should continue, especially in young and diabetic individuals where high sympathetic tone and high renin levels are the primary features. The newer-generation vasodilating beta blockers have favorable hemodynamic and metabolic properties, better side effect profile and improved efficacy in treating uncomplicated hypertension. With the advent of these new agents, the beta blocker class should remain as a viable first-line option in antihypertensive therapy.
β受体阻滞剂作为高血压治疗的一线药物已有很长的历史。它们是缺血性心脏病、心力衰竭、高危冠状动脉疾病和心律失常治疗的主要药物，因为它们在这些明确适应症中的重要性已得到充分确立。然而，β受体阻滞剂在单纯性高血压治疗中的疗效和相关性受到了质疑，因为传统药物在心血管结局方面被认为不如其他类别的药物。尽管阿替洛尔和其他传统药物已失宠，但其他心脏选择性药物已被证明在高血压治疗中至少与其他类药物一样有效。它们在高血压治疗中的应用应继续，特别是在年轻和糖尿病个体中，这些个体的主要特征是交感神经张力高和肾素水平高。新一代血管舒张性β受体阻滞剂具有良好的血流动力学和代谢特性、更好的副作用谱以及在治疗单纯性高血压方面提高的疗效。随着这些新药的出现，β受体阻滞剂类应仍然是抗高血压治疗中可行的一线选择。
