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Certain beta blockers (e.g., bisoprolol) may be reevaluated in hypertension guidelines for patients with left ventricular hypertrophy to diminish the ventricular arrhythmic risk

Journal of Human Hypertension volume 35, pages 564–576 (2021)Cite this article

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Abstract

Hypertensive left ventricular hypertrophy (HTN LVH) is associated with almost threefold increased risk of ventricular tachycardia (VT)/ventricular fibrillation (VF). Furthermore, HTN LVH increases the risk of sudden cardiac death (SCD). The reverse LV remodeling due to efficient antihypertensive therapy lowers the incidence rates of cardiovascular events and SCD and the vast majority of available arterial hypertension (HTN) guidelines recommend renin angiotensin system (RAS) blockers and calcium channel blockers (CCBs) for HTN LVH aiming for LVH regression. On the other hand, beta blockers (BBs) as a class are not recommended in HTN LVH due to their insufficient capacity to reverse LVH remodeling even though they are recommended as the first-line drugs for prevention/treatment of VT/VF (in general, unrelated to HTN LVH). Moreover, BBs are the best antiarrhythmic (against VT/VF) among antihypertensive drugs. Despite that, BBs are currently not recommended for LVH treatment in HTN Guidelines. It is important to prevent VT/VF in patients at high risk, such as those with HTN LVH. Therefore, certain BBs (such as Bisoprolol) may be reevaluated in guidelines for HTN (in the section of HTN LVH).

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Acknowledgements

This work has been supported by the Serbian Ministry of Education and Science, Belgrade, Serbia, grants No.175092 and No. III41018.

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Authors and Affiliations

  1. Department for Cardiovascular Diseases, Clinical Center Nis, Nis, Serbia

    Goran Koracevic

  2. Faculty of Medicine, University of Nis, Nis, Serbia

    Goran Koracevic

  3. Institute for Treatment and Rehabilitation Niska Banja, Nis, Serbia

    Milovan Stojanovic

  4. Clinic for Internal Diseases Inter Medica, Nis, Serbia

    Dragan Lovic

  5. Singidunum University, School of Medicine, Belgrade, Serbia

    Dragan Lovic

  6. University Hospital Medical Center Bezanijska Kosa, Belgrade, Serbia

    Marija Zdravkovic

  7. Institute for Cardiovascular Diseases of Vojvodina, Sremska Kamenica & Medical Faculty Novi Sad, Novi Sad, Serbia

    Dejan Sakac

Authors
  1. Goran Koracevic
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  2. Milovan Stojanovic
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  3. Dragan Lovic
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Correspondence to Milovan Stojanovic.

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Koracevic, G., Stojanovic, M., Lovic, D. et al. Certain beta blockers (e.g., bisoprolol) may be reevaluated in hypertension guidelines for patients with left ventricular hypertrophy to diminish the ventricular arrhythmic risk. J Hum Hypertens 35, 564–576 (2021). https://doi.org/10.1038/s41371-021-00505-8

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  • DOI: https://doi.org/10.1038/s41371-021-00505-8

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