Beta-blockade should not be among several choices for initial therapy of hypertension

摘要

It is surprising that the current guidelines for the treatment of hypertension given by the joint task forces of the European Society of Hypertension (ESH) and the European Society of Cardiology (ESC) propose that 'any BP lowering agent' is suitable for initiation of and maintenance of antihypertensive treatment, including beta-blockers in their Box 10 . There are now many substantial arguments against the use of beta-blockers as first line agents, some of which are already given in the text of the guidelines but not in the Box except for warning against use in the metabolic syndrome or those at risk of new incident diabetes. These arguments against initial beta-blocker therapy for hypertension include the following