Insights on β-blockers for the treatment of hypertension: A survey of health care practitioners.
Brent M EganJohn FlackMehul PatelSofia LomberaPublished in: Journal of clinical hypertension (Greenwich, Conn.) (2018)
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.
Keyphrases
- primary care
- angiotensin converting enzyme
- blood pressure
- healthcare
- heart rate
- weight gain
- angiotensin ii
- general practice
- type diabetes
- heart rate variability
- body mass index
- cardiovascular disease
- high resolution
- cross sectional
- birth weight
- insulin resistance
- metabolic syndrome
- adipose tissue
- combination therapy
- mass spectrometry
- bone marrow