BMJ  2007;334:946-949 (5 May), doi:10.1136/bmj.39185.440382.47

Clinical Review

blockers in hypertension and cardiovascular disease

H T Ong Heart Clinic, 251C Burma Road, Penang, Malaysia

This review provides practical pointers on the use of blockers for the non-specialist clinician

The first 150 words of the full text of this article appear below.

blockers are useful in managing angina and reducing mortality after myocardial infarction and in heart failure. They probably reduce cardiovascular events in high risk surgery and retard the progression of atherosclerosis. In younger patients, blockers should remain first line antihypertensives, together with diuretics, calcium channel blockers, angiotensin converting enzymes, and adrenergic receptor binders; choice depends on the individual case.

Not all blockers are equivalent in cardiovascular protective effects, and atenolol seems inferior to other antihypertensive drugs in reducing stroke and total mortality. Recent publications have found that blockers are less effective than other antihypertensive drugs in preventing cardiovascular outcomes in hypertensive patients.^{1 2 3} In interpreting the new data, it is important to integrate these new results with previous trials and meta-analyses.

The references in the ASCOT trial,1 recent meta-analyses of treatment with blockers,2 3 and guidelines of hypertension societies (Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure . . . [Full text of this article]

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The tolerability of different beta blockers also varies depending on whether or not there is co-existent airflow obstruction

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