Indications for beta-adrenoceptor blocking drugs in hypertension.

The past 10 years have firmly established the role of beta-adrenoceptor blocking agents in the treatment of hypertension. They have been shown to lower systolic and diastolic blood pressure in the lying and standing position in mild, moderate and severe hypertension. Precise indications for beta-blockade have not yet been completely defined. Some authorities regard them as the drug of first choice in the management of most grades of idiopathic hypertension. There are in addition certain situations where beta-blockade seems especially suitable. These include the presence of associated coronary heart disease manifest either as angina pectoris or dysrhythmia. These agents can be introduced when side effects from other drugs are severe or intolerable and are valuable in the management of hypertensive young males since beta-blocking drugs do not interfere with sexual function. Compared with normotensive subjects 'stress' has been shown to produce excessive rise of blood pressure in those with labile or sustained idiopathic hypertension. After therapy with beta-blocking agents the rise in blood pressure after 'stress' is reduced. If labile and/or mild hypertension are the precursors of subsequently more severe sustained hypertension, then long term beta-blockade may help to control this response.