An algorithm for selection of antihypertensive therapy, a place of long-acting beta-blockers
M.D. Smirnova, F.T. Ageev

National Medical Research Center of Cardiology, Moscow

The article is devoted to reassessment of the role of beta-blockers (BB) in the arterial hypertension (AH) treatment, reflected in the new version of joint recommendations on AH of the European Society of Cardiology and the European Society of Hypertension 2018. BB can be prescribed as antihypertensive drugs in presence of specific clinical situations such as chronic heart failure (CHF), angina pectoris, a previous myocardial infarction (MI), need for rhythm control, pregnancy or its planning. In addition, they can be used as a third-step drug in resistance to the therapy. As absolute contraindications to BB included bradycardia (heart rate less than 60 beats per minute) and excluded chronic obstructive pulmonary disease. Prerequisites of this reassessment are considered and analyzed, a data of the last meta-analyzes devoted to drugs of the first line of AH treatment is presented. Indications for use of different BB are considered. Features of pharmacokinetics, pharmacodynamics of clinical application of various salts of metoprolol (succinate and tartrate) are presented. A data on efficacy and safety of metoprolol succinate use in AH in combination with coronary heart disease, CHF is presented.

Key words: beta-adrenoblockers, metoprolol, metoprolol succinate, Betaloc^® ZOK, arterial hypertension, chronic heart failure, coronary heart disease, cardiovascular diseases.
For citation: Smirnova M.D., Ageev F.T. An algorithm for selection of antihypertensive therapy, a place of long-acting beta-blockers // RMJ. 2018. № 11(I). P. 42–46.