The Modern Role of Beta-Blockers in Cardiovascular Medicine
The Modern Role of Beta-Blockers in Cardiovascular Medicine is a valuable tool for medical students as well as cardiovascular practitioners and internists worldwide. This pocket manual provides a concise guide to beta-blocker use in the cardiovascular area, particularly hypertension and heart failure.
Beta-blockers (BBs) are a large and important family of therapeutic agents with primary use in cardiovascular medicine. The therapeutic areas that BBs cover include: ischemic heart disease, hypertension, heart failure, and arrhythmias.
Chapter 1- Pharmacology
Introduction
Nature of the beta-receptor
Pharmacodynamics
Pharmocokinetics
Summary and Conclusions
References
Chapter 2 – Ischaemic heart disease, peripheral arterial disease and atheroma
Introduction
Angina pectoris and chronic ischaemia
Peripheral arterial disease
The atheromatous plaque
Summary and conclusions
References
Chapter 3 –Hypertension
Introduction
Recent anti-BB sentiment
Patho-physiology of primary hypertension
Major hard-end point randomised, controlled studies involving first-line BBs in young/middle age
Major hard-end –point, randomised, controlled studies with first-line BBs in elderly systolic hypertension
Effects on left ventricular hypertrophy
Major hard-end-point, controlled, randomised studies with BBs given second-line to diuretics
Are drug-induced metabolic changes harmful?
Where do angiotension receptor blockers (ARB) fit in?
So how did the UK NICE Committee get it so wrong?
Secondary hypertension a) Renal disease b) Phaeochromocytoma c) Pregnancy
Is choice of BB important?
Summary and Conclusions
References
Chapter 4 – Arrhythmias
Introduction (types of anti-arrhythmic agents)
Management of arrhythmias with beta-blockers
Is choice of BB important?
Summary and Conclusions
References
Chapter 5 – Heart failure
Introduction
Two main types of heart failure
BBs and mortality in HFREF
Mechanisms of BB benefit
New approach to end-stage heart failure (combination of beta-1 blockade with beta-2 stimulation)
Diastolic heart failure (HFNEF)
Contra-indications to BBs
Heart failure prevention
Choice of BB (avoid ISA)
Summary and conclusions
References
Chapter 6 – Adverse reactions
Introduction
Quality of life
Adverse reaction relating to cardiovascular system
Adverse reactions relating to renal function
Adverse reactions relating to respiratory system
Metabolic disturbance
Central nervous system
Sexual dysfunction
Weight gain
Skin and Rashes
Summary and Conclusions
References