Beta Blockers and their Combinations in the Management of Hypertension

Beta blockers have been prescribed for the treatment of primary hypertension for a very long time. Currently; it is doubtful whether this is still a good idea. In fact; many are of the opinion that beta blockers should be relegated to a fourth-line drug; if used at all; for the treatment of hypertension. So what happened? Why the change of heart? Basically; two issues are driving this new view of beta blockers.Firstly; beta blockers are cardioprotective when given to patients with a recent myocardial infarction and reduce subsequent mortality significantly. Certain types of beta blockers reduce mortality in patients with heart failure. This efficacy in secondary protection was translated to primary prevention without a critical assessment; and this is particularly the case in hypertension.Secondly; reducing blood pressure by any means may not automatically translate into reduced cardiovascular morbidity and mortality. This happened with beta blockers in the primary treatment of hypertension

From Bowditch to Beta-Blockers : Evolution of the Understanding of the Importance of Heart Rate and Myocardial Energetics in Cardiomyopathy

During the past three decades; every aspect of cardiomyopathy has undergone dramatic change. When examining the literature on the physiological aspects of the failing heart; one immediately recognises that South Africa has made a contribution : Brink; Bester and Lochner evaluated the possible therapeutic aspects of the Bowditch phenomenon and myocardial energetics in cardiomyopathy almost four decades ago; at a time when the condition even had another name; myocardiopathy

L'actualite sur le traitement de l'hypertension arterielle

L'hypertension arterielle est devenue pour le monde entier un reel probleme de sante publique et constitue un facteur de risque cardiovasculaire majeur. Elle accelere l'installation de l'attaque herosclerose coronaire et cerebrovasculaire. Les mecanismes de la potentialisation de l'atherogenese dans l'hypertension arterielle se revelent fort complexes. L'approche therapeutique qui constitue la substance de ce texte est donc empirique. Actuellement on pense que les beta-bloquants et les inhibiteurs de l'enzyme de conversion seront prescrits avant 50 ans; les diuretiques et les inhibiteurs calciques apres 50 ans