Pharmacokinetic and pharmacodynamic properties of beta-blocking drugs influencing choice in treatment of systemic hypertension

The American Journal of Cardiology
D C Harrison

Abstract

Diuretics and beta blockers are the mainstay in treating mild and moderate systemic hypertension, but there is controversy as to which should be used first. Recent evidence of an increase in sudden death and a greater number of intolerable side effects in the diuretic-treated groups in the Multiple Risk Factor Intervention Trial in the U.S. and the Medical Research Council Trial in Great Britain has prompted some to suggest beta blockers as first-line therapy. However, beta blockers also have side effects, such as decreased ventricular function in patients with mild heart failure, increased airways resistance in those with chronic obstructive lung disease, increased plasma lipids, in particular low density lipoprotein cholesterol, and increased problems in patients with peripheral vascular disease and those with diabetes requiring insulin treatment. Many new beta-blocking drugs with different pharmacokinetic and pharmacodynamic properties allow the physician to choose the best one for each patient. beta-blocking drugs with long durations of action, high levels of bioavailability, beta 1 selectivity and intrinsic sympathomimetic activity appear most suitable for therapy. Cardioselectivity is suggested for patients with obstructi...Continue Reading

References

May 1, 1977·Circulation·A H GradmanD C Harrison
Jan 1, 1985·Journal of Cardiovascular Pharmacology·P A van Zwieten, P B Timmermans
Jan 1, 1985·Journal of Cardiovascular Pharmacology·L HanssonA Zanchetti
Apr 26, 1985·The American Journal of Cardiology·D C Harrison
Jun 1, 1985·Archives of Internal Medicine·M H Weinberger
Mar 1, 1980·Circulation·G JacksonD C Harrison

Citations

Jul 1, 1988·American Heart Journal·G Z Khair, M S Kochar
Mar 12, 2015·European Journal of Pharmaceutics and Biopharmaceutics : Official Journal of Arbeitsgemeinschaft Für Pharmazeutische Verfahrenstechnik E.V·D SchönherrW Weitschies
Nov 1, 1988·Psychological Medicine·L Kuipers, P Bebbington

Related Concepts

Adrenergic beta-Antagonists
Angiotensin-Converting Enzyme Inhibitors
Biological Availability
Diastolic Blood Pressure
Calcium Channel Blockers
Hypertensive Disease
Sympathomimetic Effect

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