beta-Adrenergic receptor blockers or P-blockers represent one of the oldest classes of cardiovascular agents and have been considered a cornerstone therapy for hypertension and heart disease for the past 5 decades. They are advocated as a first-line treatment for uncomplicated essential hypertension in patients younger than 60 years of age as recommended by the Canadian Hypertension Education Program. However, despite the well-established antihypertensive and cardiovascular benefits of (3-blockers, a number of studies argue that they might not have the same clinical advantages of other classes of agents in terms of morbidity/mortality outcomes. This review will focus on the heterogeneity of the pharmacologlc characteristics of P-blockers, and we will discuss the metabolic and hemodynamic differences within the (3-blocker class and try to assess the potential implications of these differences for optimal selection in hypertension.
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