Keypoints about the use of Beta Blockers

Major points about the use of betablockers 

1-All betablockers can cause reduction in HDL level except CARVEDILOL

2-All betablockers can cause hypertriglyceridaemia except CARVEDILOL

3-The betablocker of the choice in renal patients on dialysis+HF is CARVEDILOL

4-Target dose of CARVEDILOL is patients with HFrEF is 25mg twice (50mg twice if body weight 85Kg or more )

5-The best antihypertensive effect among betablockers is observed with CARVEDILOL and nebivilol

6-The best rate controlling effect among betablockers is observed with bisoprolol and metoprolol

7-The most selective beta1 blocker is nebivilol, so it the most suitable for patients with asthma or COPD

8-The lowest incidence of erectile dysfunction among betablockers is observed with Nebivilol, it improves ED due to its vasodilating properties.

9-Betablocker can control HR in AF during rest and exercise(while digoxin control HR at rest only)

10-Betablockers are considered the fifth antihypertensive drug (after ACEI, ARBs, CCB, thiazide diuretics) except in pregnancy, Arrhythmias(AF), angina or HF ; in these cases, Betablocker can be used as first line for hypertension.

11- Metoprolol tartarate has short half life so should be given twice daily, whereas succinate has long half life which pwrmits once daily dosing