The Modern Role of Beta-Blockers in Cardiovascular Medicine

ISBN: 978-1-60795-108-7




November 2010

ISBN: 978-1-60795-108-7

John Malcolm Cruickshank M.D

Independent Cardiovascular consultant

University College Hospital, London

Withington Hospital, Manchester, UK

E-Book version available for purchase and download now to your iPad or iPhone and other devices (USA only).



This pocket manual is a valuable tool for medical students as well as cardiovascular practitioners and internists worldwide, and provides a concise and much-needed update of beta-blocker use in the cardiovascular area (particularly hypertension and heart failure).

Beta-blockers (BBs) are a large and important family of therapeutic agents with primary use is in cardiovascular medicine.  The therapeutic areas that BB covers include:  Ischemic Heart Disease, Hypertension, Heart Failure and Arrhythmias.

It also provides a current update of the vital role of beta-blockers in the treatment of heart failure, and why some beta-blockers are “ineffective”. 

The book also uncovers the clinical inaccuracies of how the UK NICE (National Institute for Clinical Excellence) Committee have “got it wrong” in their recent pronouncements on BBs and hypertension.

Detailed Table of Contents
Chapter 1- Pharmacology
A.       Introduction
B.       Nature of the beta-receptor
C.       Pharmacodynamics
D.       Pharmocokinetics
E.       Summary and Conclusions
F.        References

Chapter 2Ischaemic heart disease, peripheral arterial disease and atheroma
A.       Introduction
B.       Angina pectoris and chronic ischaemia.
C.       Peripheral arterial disease
D.       The atheromatous plaque
E.       Summary and conclusions
F.        References

Chapter 3Hypertension
A.       Introduction
B.       Recent anti-BB sentiment (UK NICE Committee views)
C.       Patho-physiology of primary hypertension
D.       Major hard-end point randomised, controlled studies involving first-line BBs in young/middle age
E.       Major hard-end –point, randomised, controlled studies with first-line BBs in elderly systolic hypertension
F.        Effects on left ventricular hypertrophy
G.       Major hard-end-point, controlled, randomised studies with BBs given second-line to diuretics
H.       Are drug-induced metabolic changes harmful?
I.         Where do angiotension receptor blockers (ARB) fit in?
J.         So how did the UK NICE Committee get it so wrong?
K.       Secondary hypertension a) Renal disease b) Phaeochromocytoma c) Pregnancy
L.       Is choice of BB important?
M.      Summary and Conclusions
N.       References

Chapter 4Arrhythmias
A.       Introduction (types of anti-arrhythmic agents)
B.       Management of arrhythmias with beta-blockers
C.       Is choice of BB important?  
D.       Summary and Conclusions
E.       References

Chapter 5Heart failure
A.       Introduction
B.       Two main types of heart failure
C.       BBs and mortality in HFREF
D.       Mechanisms of BB benefit
E.       New approach to end-stage heart failure (combination of beta-1 blockade with beta-2 stimulation)
F.        Diastolic heart failure (HFNEF)
G.       Contra-indications to BBs
H.       Heart failure prevention
I.         Choice of BB (avoid ISA)
J.         Summary and conclusions
K.       References

                                                        Chapter 6Adverse reactions
A.       Introduction
B.       Quality of life
C.       Adverse reaction relating to cardiovascular system
D.       Adverse reactions relating to renal function
E.       Adverse reactions relating to respiratory system
F.        Metabolic disturbance
G.       Central nervous system
H.       E) Sexual dysfunction
I.         F) Weight gain
J.         Skin and Rashes
K.       Summary and Conclusions I References