European heart journal
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European heart journal · Jul 1983
Comparative StudyHaemodynamic consequences of intrinsic sympathomimetic activity and cardioselectivity in beta-blocker therapy for hypertension.
The relevance of intrinsic sympathomimetic activity (ISA) and cardioselectivity for the acute and long-term haemodynamic effects of beta-blocker therapy for hypertension was assessed from reports in the literature. The beta-blockers included in this survey are pindolol, practolol, alprenolol, oxprenolol, acebutolol, penbutolol, metoprolol, atenolol, propranolol and timolol. Forty-four acute and 41 long-term studies in 430 and 482 subjects respectively, were analysed. ⋯ Thus, the absolute value of vascular resistance during beta-blocker therapy is determined by the degree of ISA, irrespective of the quality of cardioselectivity. Consequently, beta-blockers with sufficient ISA to prevent disturbance of tissue perfusion at rest reduce the characteristically elevated vascular resistance in longstanding arterial hypertension in contrast with beta-blockers lacking this property. This can have implications for the long-term prognosis of this condition.