Abstract

Beta-blockers are the cornerstone of management for chronic heart failure, acute myocardial infarction and atrial fibrillation. Despite the fact that beta-blockers have been used as antihypertensives for over half a century, their use in uncomplicated primary arterial hypertension remains controversial. It has recently been shown that beta-blockers are inferior to other antihypertensive drug classes in prevention of cardiovascular diseases, especially stroke. However, as atenolol is the best studied beta-blocker and as there is substantial heterogeneity between the subclasses of the beta-blockers, this might not reflect a class effect. This review article gives a survey of the pharmacodynamics and -kinetics of beta-blockers as well as of recent studies and management guidelines on their use in arterial hypertension.