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Keypoints about the use of Beta Blockers

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Major points about the use of betablockers 

1-All betablockers can cause reduction in HDL level except CARVEDILOL


2-All betablockers can cause hypertriglyceridaemia except CARVEDILOL


3-The betablocker of the choice in renal patients on dialysis+HF is CARVEDILOL


4-Target dose of CARVEDILOL is patients with HFrEF is 25mg twice (50mg twice if body weight 85Kg or more )


5-The best antihypertensive effect among betablockers is observed with CARVEDILOL and nebivilol


6-The best rate controlling effect among betablockers is observed with bisoprolol and metoprolol


7-The most selective beta1 blocker is nebivilol, so it the most suitable for patients with asthma or COPD


8-The lowest incidence of erectile dysfunction among betablockers is observed with Nebivilol, it improves ED due to its vasodilating properties.


9-Betablocker can control HR in AF during rest and exercise(while digoxin control HR at rest only)


10-Betablockers are considered the fifth antihypertensive drug (after ACEI, ARBs, CCB, thiazide diuretics) except in pregnancy, Arrhythmias(AF), angina or HF ; in these cases, Betablocker can be used as first line for hypertension.


11- Metoprolol tartarate has short half life so should be given twice daily, whereas succinate has long half life which pwrmits once daily dosing

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