[Pharmacology of beta blockers and their significance for therapy of hypertension].

Introduction: Beta blockers are of great importance in the treatment of arterial hypertension, coronary heart disease, cardiac arrhythmias and heart failure. Their effects are mediated by the blockade of various alpha- und beta-receptors and specific com-pounds have been developed to address them.

Pharmacology: Nonselective beta blockers (e.g. propranolol, nadolol, penbutolol, carvedilol) are to be separated from beta 1-selective blockers (e.g. metoprolol, atenolol, bisoprolol). Selectivity is never absolute and all beta blockers can cause problems in allergic asthma. Another important aspect is the intrinsic-sympathomimetic activity of some compounds (e.g., pindolol, oxprenolol).

Clinical Application: Together with diuretics, beta blockers are the oldest "modern" antihypertensive drugs. Only recently, interest has been raised because of their application in a hitherto forbidden indication, namely heart failure. In many patients, more than one indication applies to beta blockers, and differential therapy is able to cope with several conditions by one drug. Hypertension, atrial fibrillation and heart failure are often associated diseases as hypertension is a risk factor for both other diseases.