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Contraindications Differ Widely Among Beta Blockers and Ought to be Cited for an Individual Drug, Not for the Entire Class

Author(s):

Goran Koraćević , Milovan Stojanović *, Tomislav Kostić , Dragan Lović, Marija Zdravković, Maja Koraćević, Dimitrije Pavlović and Slađana Mićić   Pages 1 - 8 ( 8 )

Abstract:


Beta blockers (BBs) have important side effects that contribute to low adherence and persistence. Therefore, the optimal choice of BB is an important mode to prevent BB’s side effects, leading to an increase in compliance, which can improve the outcomes in BBs' evidence-based indications, such as acute myocardial infarction, heart failure, etc. The aim of the paper is to suggest an improved method of reporting contraindications for BBs. We used a search of the following indexing databases: SCOPUS and PubMed, and web search engine Google Scholar to identify guidelines on arterial hypertension (HTN). HTN guidelines published during the last 2 decades were analyzed (from 2000 to 2020). Some of the contraindications (e.g., bradycardia, acute heart failure) are true for every BB. However, some contraindications do not belong to the whole BB class. For example, propranolol and carvedilol are contraindicated in chronic obstructive lung disease, but nebivolol and bisoprolol are not. We suggest that contraindications which are specific for some BBs (i.e., not for the whole class) ought to be listed with the exact name(s) of the individual BBs. In this way, we may decrease the number of wrong choices among BBs and consequently increase drug adherence (which is currently worse for the class of BBs than for most of the other antihypertensive drugs). To our knowledge, there is a lack of guidelines citing contraindications for individual BBs, because they vary a lot within-the-class of BBs. This is an approach to improve both basic medical education and guidelines.

Keywords:

Beta blockers, contraindications, chronic obstructive lung disease, heart failure, acute myocardial infarction, arterial hypertension, drug adherence.

Affiliation:

Department for Cardiovascular Diseases, Clinical Center Niš, Institute for Treatment and Rehabilitation Niška Banja, Niš, Department for Cardiovascular Diseases, Clinical Center Niš, Clinic for Internal Diseases Inter Medica, Nis, University Hospital Medical Center Bezanijska Kosa, Belgrade, Faculty of Medicine, University of Niš, Clinic for Plastic and Reconstructive Surgery, Clinical Centre Nis, Nis, Faculty of Medicine, University of Niš



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