Beta Blockers are Good Choice as First line Antihypertensive Agents

For more than 3 decades beta blockers have been widely used in the treatment of hypertension and are still recommended as first line agents (1,2). Beta blockers have been in use not only in hypertension but in other cardiovascular conditions. Since long period, beta blockers have assumed a guideline-recommended treatment option for hypertension. However, recent meta-analyses have questioned whether beta blockers are an appropriate therapy given outcomes data for other antihypertensive drug classes. Much of the unfavorable reports were from studies involving non vasodilating, traditional beta blockers such as atenolol. Vasodilatory beta blockers (carvedilol, nebivolol, bisoprolol) reduce blood pressure (BP) by reducing systemic vascular resistance while maintaining cardiac output rather than reducing cardiac output as is observed in atenolol, propanolol. Vasodilatation may also ameliorate adverse effects on metabolic and lipid parameters including an increased risk for new onset diabetes. In patients with hypertension and diabetes or coronary artery disease, vasodilating beta blockers cause effective BP control with neutral or beneficial effects on important parameters for the comorbid disease (3).