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23 July 2007
Beta-blockers have long been established in the treatment of hypertension. They are particularly useful in hypertensive patients with effort angina, tachyarrhythmias or previous myocardial infarction where they have been shown to reduce cardiovascular morbidity and mortality. Certain beta-blockers such as carvedilol, bisoprolol and long-acting metoprolol have been shown to be beneficial in patients with heart failure.

Beta-blockers are contraindicated in patients with obstructive airways disease, severe peripheral vascular disease and heart block. They are generally well tolerated. Adverse effects reported include dyslipidaemia, masking of hypoglycaemia, erectile dysfunction, nightmares and cold extremities.

Beta blocker
Starting Dose
Recommended Maximum Dose
Acebutalol 200 mg 800 mg
Atenolol25 mg 100 mg
Betaxolol 5 mg 20 mg
Bisoprolol 2.5 mg 10 mg
Carvedilol 12.5 mg50 mg
Labetalol 200 mg 1200 mg
Metoprolol 50 mg 400 mg
Propranolol 40 mg 320 mg

Table 13: Beta-blockers commonly used for the treatment of hypertension in Malaysia.

Clinical Practice Guidelines on the Management of Hypertension

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