Nebivolol as a first-line antihypertensive: a justifiable proposal?

β-Blockers (BBs) have long been used to treat hypertension (HBP). The mechanisms of their antihypertensive effects include negative chronotropy and inotropy, inhibition of β-adrenergic receptor-mediated peripheral vasoconstriction and central adrenergic outflow, as well as renin release.1 Additionally, newer BBs such as nebivolol have direct peripheral vasodilatory activity and other properties which distinguish them from first-generation and second-generation agents (table 1). In this issue of Heart Asia, Kim et al2 commend the use of BBs, and specifically nebivolol, as a first-line agent for HBP. Table 1Classification, properties and cost of β-blockers available at National University, Singapore Half-life (h)β-1 Receptor selectivityLipophilic/hydrophilicIntrinsic sympathomimetic activityPeripheral vasodilationUsual dose range (mg/days)Daily cost at lower and upper end of usual dosing (SGD)First generation Propranolol3–4
Source: Heart Asia - Category: Cardiology Authors: Tags: Editorial Source Type: research