Institute of Cardiology, Catholic University of the Sacred Heart, Policlinico A. Gemelli, Largo A. Gemelli, 8, 00168, Rome, Italy.
Curr Atheroscler Rep. 2011 Apr;13(2):147-53. doi: 10.1007/s11883-010-0157-9.
National and international guidelines still recommend β-blockers (BBs) as first-line agents in uncomplicated prevention of hypertension. However, it has been shown that BBs reduce blood pressure less than other drugs, specifically with regard to central aortic pressure. More importantly, recent meta-analyses have highlighted that in primary prevention BBs are associated with a relatively weak effect in reducing stroke compared to placebo or no treatment and, compared with other drugs, show evidence of a worse cardiovascular outcome. Several reasons might explain their mild cardioprotective effect, such as their unfavorable metabolic properties, a lack of efficacy on left ventricular hypertrophy regression and endothelial dysfunction, and reduced patient compliance. Thus, the available evidence does not support the use of BBs as first-line drugs in the treatment of uncomplicated hypertension. It remains to be determined whether newer BBs, such as nebivolol and carvedilol, will be more effective than older compounds in improving cardiovascular prognosis.
国家和国际指南仍推荐β受体阻滞剂（BBs）作为治疗单纯性高血压的一线药物。然而，已经证明 BBs 降低血压的效果不如其他药物，特别是在降低主动脉压方面。更重要的是，最近的荟萃分析强调，在一级预防中，与安慰剂或不治疗相比，BBs 降低卒中的效果相对较弱，与其他药物相比，有心血管预后恶化的证据。有几个原因可以解释它们温和的心脏保护作用，例如它们不利的代谢特性、对左心室肥厚消退和内皮功能障碍的疗效不足，以及降低了患者的依从性。因此，现有证据不支持将 BBs 作为治疗单纯性高血压的一线药物。尚不确定新型 BBs（如奈必洛尔和卡维地洛）是否比旧化合物更能改善心血管预后。
