Betabloqueadores Lo bueno, Lo feo, Lo malo de sus efectos
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comparacion de los efectos buenos, feos y malos de los betabloqueadores en hipertension arterial
Transcript of Betabloqueadores Lo bueno, Lo feo, Lo malo de sus efectos
10 20 30 40 50 60
High BP
CAD
CHF
Stroke
Other
50,000,000
12,200,000
4,600,000
4,400,000
2,800,000
Prevalence (millions)
BP=blood pressure, CAD=coronary artery disease, CHF=congestive heart failure
American Heart Association® . 2000 Heart and Stroke Statistical Update. 1999.
(24%)
Eyes• Retinopathy
Kidneys• Nephropathy
Vasculature• Peripheral arterial
disease
Cerebral• Stroke• Transient ischemic
attack
Heart Disease• Angina• Myocardial infarction• Left ventricular
hypertrophy• Heart failure• Coronary revascularization
From Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Arch Intern Med. 1997;157:2413-2446.
Sustaining a 12 mmHg reduction in SBP over 10 years will prevent one death for every 11 patients treated with Stage I HTN with additional CVD risk factors
Why treat hypertension?
◦ 35-40% in stroke morbidity and mortality
◦ 20-25% CAD events
◦ 21% vascular mortality
◦ 52% in CHF
◦ 35% in LVH
CountryDiagnosed
HypertensiveAware Treated Controlled
US 24% 42% 52% 24%
UK 19% 63% 50% 30%
France 41% 79% 59% 24%
Germany 53% 12% 32% 22%
Canada 22% 59% 40% 16%
Italy 58% 79% 51% 19%
China 14% 26% 12% 3%
Chockalingam, Am J Hypertens, 1998; Chamontin et al, Am J Hypertens, 1998; Marques-Vidal et al, Q J Med, 1997; Trenkwalder et al, J Hypertens, 1994; Vincenzi et al, G Ital Cardiol, 1992; Colhoun et al, J Hypertens, 1998; Franklin et al, Hypertension, 2001; Tao et al, Chin Med J, 1995.
BisoprololBloqueante beta-adrenérgico altamente cardioselectivo, con acción receptores β-1 .Escasa afinidad por los receptores β-2 de lamusculatura lisa bronquial y vascular, así como por los receptores β-2 implicados en laregulación metabólica.
USADA guide to prohibited classes of substances and prohibited methods of doping. Retrieved October 2001, from http://www.usantidoping.org/prohibited_sub/guide.asp.
Lancet. 2005;366:1545-53.
Age under 55 years
Aged over 55 years orblack person of African
or Caribbean familyorigin of any age
A C
A + C
A + C + D
Resistant hypertensionA + C + D + consider further
diuretic or alpha- orbeta-blocker
Consider seeking expert advice
KeyA – ACEI orARBC – CCBD – Thiazide like diuretic
Hypertension
Volume 59(4):893-898
March 14, 2012
Risk/Benefit Assessment of β-Blockers
and Diuretics Precludes Their Use for
First-Line Therapy in Hypertension
by Franz H. Messerli, Sripal Bangalore, and Stevo Julius
Circulation
Volume 117(20):2706-2715
May 20, 2008
Copyright © American Heart Association
Figure 6. Risk of new-onset diabetes
mellitus with antihypertensive treatment.
Messerli F et al. Circulation 2008;117:2706-2715
Copyright © American Heart Association
ARCH INTERN MED/VOL 170 (NO. 10), MAY 24, 2010
Ankle-brachial index in the 2 treatment groups at baseline
and after the 48 week treatment period.
Espinola-Klein C et al. Hypertension 2011;58:148-154
Copyright © American Heart Association
