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- W1497472292 abstract "Hypertension is currently one of the chronic diseases most frequently encountered in clinical practice, affecting a growing number of people worldwide. According to the World Health Organization, the prevalence of hypertension in people over 25 years is approximately 40%, with one billion patients being considered as uncontrolled hypertensives in 2008. Hypertension is also associated with increased cardiovascular events including acute myocardial infarction, stroke, chronic renal failure and finally death. At present there are ample pharmacological tools to manage hypertension including beta blockers, diuretics, calcium channel blockers, angiotensin converting enzymes inhibitor and angiotensin receptor inhibitor, among other agents. Although blood pressure is similarly reduced by these antihypertensive drugs, the long term benefits and the type of adverse events are not the same. As an example, beta blockers were considered a first-line treatment for this disease; however, in the last hypertension clinical guideline published in the United States, the JNC-8 (1) as well as in other clinical guidelines such as NICE in the United Kingdom, (2) this family of drugs was excluded as one of the initial therapies for hypertension. This decision was based on the increased incidence of cardiovascular events, such as cardiac death, acute myocardial infarction and stroke associated with the use of beta blockers, compared with other antihypertensive agents. Of note, these issues regarding the safety of beta blockers are mainly derived from studies with atenolol (3) and metoprolol. (4) Unfortunately, there is no similar evidence from clinical trials on the novel beta blockers with more powerful vasodilatory effect, such as carvedilol and nebivolol, which in addition have a lower risk of developing diabetes compared with classical beta blockers. The mechanism by which hypertension produces organ injury has not been clearly established. The hypothesis of mean blood pressure has been the most plausible; however, it only partially explains the pathophysiology of organ injury caused by hypertension. Subsequent studies have identified blood pres-" @default.
- W1497472292 created "2016-06-24" @default.
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- W1497472292 date "2015-06-05" @default.
- W1497472292 modified "2023-09-27" @default.
- W1497472292 title "Effect of Carvedilol on Blood Pressure Variability" @default.
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- W1497472292 doi "https://doi.org/10.7775/ajc.83.3.6390" @default.
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