Modern Role of Beta Blockers in Hypertension

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Slide 1 :

Modern Role of Beta Blockers in Cardiovascular Medicine Dr. __K.V.Sahasranam Senior Cardiologist Baby Memorial Hospital, Calicut

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Today’s Discussion BB in Hypertension BB and the atheromatous plaque BB in Angina pectores and chronic ischemia BB in Post Myocardial Infarction BB in Heart Failure BB in Cardiac Arrhythmias Adverse Reactions to Beta Blockers

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Bisoprolol position

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Kinetic comparison Borchard U. ß-Rezeptorenblocker, Klinik und Praxis, Aesopus Verlag 1996 * Variable kinetics depending on the metabolic status

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Wellstein A et al. J Cardiovasc Pharmacol 1986;8(Suppl. 11):36–40 Wellstein A et al. Eur Heart J 1987;8(Suppl. M):3–8 Highly Selective 300:1 1:35 1:35 1:75 Increasing ß1-selectivity Increasing ß2-selectivity ICI 118.551 1.8:1 Propranolol Atenolol Betaxolol Bisoprolol No selectivity Ratio of constants of inhibition 1:20 Metoprolol ß1-selectivity of bisoprolol compared with other ß-blockers

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Blood Pressure 24-hour control of blood pressure after 4-week dosing of bisoprolol 10 mg (* - - - *) compared with placebo (• - - - •) From Keim HJ, et al. Therapiewoche 1988;38:3507.

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ß-Blockers and hypertension

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Background In 1964, Brian Prichard first noted their (propranolol) antihypertensive action. ß-blockers were later to become a cornerstone in the treatment of hypertension. In developed and developing countries alike, it occurs in 25%-35% of the adult population and up to 60%-70% of those older than 60 years.

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Effects on left ventricular hypertrophy in elderly and younger hypertensives Effect of bisoprolol dosed for over 1 year on left ventricular mass (LVM) and coronary reserve flow (CRF) in 10 hypertensive patients with ischemic heart disease Motz W, Vogt M, Scheler S, et al. Dtsch Med Wochen 1993;118:535–40

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Beta blockers in Hypertension
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