In the new 2018 guidelines of the European Society of Cardiology on the management of hypertension, five classes of drugs have been retained as the base antihypertensive therapy, namely, ACE inhibitors, angiotensin II receptor blockers (ARBs), beta-blockers (BB), calcium antagonists (AC) , as well as thiazide and thiazide-like diuretics. At the same time, restrictions are made regarding BB, that they can be prescribed only in the presence of specific clinical situations, such as heart failure, angina, transferred myocardial infarction, the need for rhythm control, pregnancy or its planning.
In understanding the nature of these limitations, it makes sense to refer to the guidelines of the 2016 European Society of Cardiology, but already for the treatment of chronic heart failure, which should begin with asymptotic left ventricular dysfunction, in other words, more than far from its clinical manifestation. And as the scientists cannot show us at least one clinical example of hypertension outside at least asymptotic left ventricular dysfunction, it turns out that everyone suffering from hypertension should receive BB according to these recommendations.
If you want our point of view, the doctor always treats the patient, and not the disease, and therefore any recommendations are nothing more than an informational or at least an educational document.
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