Beta-adrenergic blocking agents in the treatment of hypertension. Choices based on pharmacological properties and patient characteristics.

Drugs that block beta-adrenergic receptors have become one of the most widely used classes of drugs to treat hypertension. This review puts the use of beta-blockers as monotherapy for hypertension in perspective and provides reasons for choosing among the several beta-blockers available. The major reasons for discriminating within this class of drugs are related to differences in concomitant clinical conditions, differences in patient responses, and intrinsic differences among the beta-blockers. These differences relate to special properties such as beta-agonist activity (intrinsic sympathomimetic activity), beta 1-selectivity, and concomitant alpha-blockade, as well as differences in side effect profiles, excretion characteristics, and length of action of the various drugs.