Clinical implications of the hemodynamic effects of beta blockade

Beta-adrenoceptor blockade produces a well-established constellation of hemodynamic effects at rest and during exercise. The beneficial clinical response in patients with hypertension and angina pectoris relates directly to these hemodynamic effects. A number of molecular modifications have accomplished more selective or additional circulatory effects designed to improve the efficacy and reduce the adverse effects of these drugs. In considering further clinical application of these agents, new data relating to the role of the sympathetic nervous system in the response to exercise, in the control of heart rate and in the progression of the syndrome of heart failure must be considered.