Kendall M J
Am J Cardiol. 1987 May 15;59(13):44F-47F. doi: 10.1016/0002-9149(87)90041-5.
Beta-adrenoceptor-blocking drugs are widely used as effective antihypertensive and antianginal agents, but treatment with these agents may be contraindicated in hypertensive patients in whom receptor blockade would interfere with noncardiovascular activities dependent on sympathetic drive. beta blockade impairs pulmonary function in asthmatic patients through antagonism of beta 2 bronchodilation. However, patients with chest problems may be treated effectively with beta 1-selective drugs, including acebutolol, atenolol and metoprolol. The metabolic response to hypoglycemia, which is mediated by beta-receptor stimulation, involves insulin release, gluconeogenesis, tachycardia and increased systolic pressure. Beta 1-selective drugs are preferred in patients who need to increase blood glucose levels because they do not interfere with glycogenolysis. Hypertension induced by pregnancy may be treated with a beta blocker with no apparent adverse effects on the fetus or neonate. Those possessing intrinsic sympathomimetic activity may be preferable.
β-肾上腺素受体阻断药被广泛用作有效的抗高血压和抗心绞痛药物，但对于那些受体阻断会干扰依赖交感神经驱动的非心血管活动的高血压患者，使用这些药物治疗可能是禁忌的。β受体阻断通过拮抗β2支气管舒张作用损害哮喘患者的肺功能。然而，患有胸部疾病的患者可以用β1选择性药物有效治疗，包括醋丁洛尔、阿替洛尔和美托洛尔。由β受体刺激介导的对低血糖的代谢反应涉及胰岛素释放、糖异生、心动过速和收缩压升高。对于需要提高血糖水平的患者，优选β1选择性药物，因为它们不会干扰糖原分解。妊娠诱发的高血压可以用β受体阻滞剂治疗，对胎儿或新生儿无明显不良影响。具有内在拟交感活性的药物可能更可取。
