Cor Vasa 2025, 67(Suppl.2):18-25 | DOI: 10.33678/cor.2025.047

(Beta-blockers in the treatment of hypertension)

Renata Cífková^{a, b}

^a Centrum kardiovaskulární prevence, 1. lékařská fakultá Univerzity Karlovy a Fakultní Thomayerova nemocnice, Praha, Česká republika

^b II. interní klinika kardiologie a angiologie, 1. lékařská fakulta Univerzity Karlovy a Všeobecná fakultní nemocnice, Praha, Česká republika

Beta-blockers are currently among the five major classes of antihypertensive drugs with a proven reduction in cardiovascular (CV) morbidity and mortality. The latest recommendations of the European Society of Hypertension (ESH) have reassessed their position in the treatment of hypertension and have included them among the drugs of the first choice in the treatment of hypertension. Prevention of cardiovascular (CV) complications in hypertension has been documented by large clinical trials for atenolol, metoprolol, oxprenolol, and propranolol. Beta-blockers are widely used in the management of hypertension accompanied by comorbidities such as chronic coronary syndrome, post-myocardial infarction, arrhythmias, angina pectoris, heart failure with reduced or preserved ejection fraction, acute coronary syndrome, atrial fibrillation, as well as in women of reproductive age or planning pregnancy and in the treatment of hypertension in pregnancy. Administration of beta-blockers is particularly indicated in hypertensive patients with a resting heart rate > 80/min. The beneficial effects of beta-blockers have been demonstrated in more than fifty clinical conditions, some of which are outside the field of CV disease. Beta-blockers may also be used in pregnancy: labetalol is considered a drug of choice for treatment of hypertension in pregnancy, while metoprolol is safe in a later phase of pregnancy being also compatible with breastfeeding.

Keywords: Antihypertensive drugs, Blood pressure, First choice treatment, Lactation, Pregnancy, Protective effect of beta-blockers

Received: March 19, 2025; Accepted: March 19, 2025; Prepublished online: June 2, 2012; Published: April 15, 2025  Show citation