Insights on β-blockers for the treatment of hypertension: A survey of health care practitioners

J Clin Hypertens (Greenwich). 2018 Oct;20(10):1464-1472. doi: 10.1111/jch.13375. Epub 2018 Oct 5.

Abstract

A quantitative survey was completed by 103 primary care physicians (PCPs) and 59 cardiologists who regularly prescribed β-blockers to assess knowledge and use of this heterogeneous drug class for hypertension. More cardiologists than PCPs chose β-blockers as initial antihypertensive therapy (30% vs 17%, P < 0.01). Metoprolol and carvedilol were the most commonly prescribed β-blockers. Cardiologists rated "impact on energy" and "arterial vasodilation" as more important than PCPs (P < 0.05/<0.01, respectively). Awareness of vasodilation was greater for carvedilol (52%) than nebivolol (31%). Association between β-blockers and clinical variables included nebivolol with β1 -selectivity, nebivolol and carvedilol with vasodilation and efficacy in older patients and African Americans, metoprolol with heart rate reduction, and atenolol and metoprolol with weight gain and hyperglycemia. Physicians preferred prescribing β-blockers with lower risk of incident diabetes. Clinical practice guidelines influenced physician prescribing more than formularies or performance metrics. This survey captures physicians' perceptions/use of various β-blockers and clinically relevant knowledge gaps.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adrenergic beta-Antagonists / adverse effects
  • Adrenergic beta-Antagonists / pharmacology*
  • Adrenergic beta-Antagonists / therapeutic use
  • Aged
  • Aged, 80 and over
  • Antihypertensive Agents / therapeutic use
  • Atenolol / adverse effects
  • Atenolol / pharmacology
  • Black or African American / statistics & numerical data
  • Cardiologists / psychology
  • Cardiologists / statistics & numerical data*
  • Carvedilol / adverse effects
  • Carvedilol / pharmacology
  • Heart Rate / drug effects
  • Humans
  • Hypertension / drug therapy*
  • Hypertension / epidemiology
  • Hypertension / mortality
  • Metoprolol / adverse effects
  • Metoprolol / pharmacology
  • Nebivolol / adverse effects
  • Nebivolol / pharmacology
  • Perception
  • Physicians, Primary Care / psychology
  • Physicians, Primary Care / statistics & numerical data*
  • Practice Guidelines as Topic
  • Surveys and Questionnaires
  • Vasodilation / drug effects

Substances

  • Adrenergic beta-Antagonists
  • Antihypertensive Agents
  • Nebivolol
  • Carvedilol
  • Atenolol
  • Metoprolol