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.
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|
| Atenolol||25 mg|| 100 mg|
| Betaxolol|| 5 mg|| 20 mg|
| Bisoprolol|| 2.5 mg|| 10 mg|
| Carvedilol|| 12.5 mg||50 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