Beta-blockers in the management of cardiovascular diseases

Beta-blockers (β-blockers) are some of the most commonly prescribed therapeutic agents and are used for a wide variety of medical conditions. In addition to being commonly used in conditions such as high blood pressure, heart failure, acute coronary syndrome, and atrial fibrillation, β-blockers can also be useful when used perioperatively for noncardiac surgery. Recently, recommendations for perioperative use of β-blockers for patients undergoing noncardiac surgery have been updated. Although some pharmacological effects of β-blockers are class effects, others are specific to an individual agent. The effect of various β-blockers on lipid profiles is mixed and there does not seem to be a consistent class effect. For these reasons, therapeutic outcomes of β-blockers, when used for a certain pathologic process, may differ from one to another. In clinical practice, β-blockers are often either under-dosed or under-prescribed. The objective of this article is to discuss some of the clinically relevant evidenced-based research and clinical trials outcomes of commonly used β-blockers.