a confused question from UW:the best choice for Antihypertensive therapy

[cliffh65]

This UW question is-
Which medication is the best choice for Antihypertensive therapy in in the patient with post-MI state. (the patient has no present complaints )

UW chooses Metoprolol instead of Propranolol.
Is this because of the more selecive beta-1 blockage of Metoprolol? or any other reasons?
Thank you any explanation.

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[skapone33]

metoprolol has had a proven decrease in morbidity and mortality in post-MI patients... maybe that will help a little

 

[Shah_Patel_PT]

This UW question is-
Which medication is the best choice for Antihypertensive therapy in in the patient with post-MI state. (the patient has no present complaints )

UW chooses Metoprolol instead of Propranolol.
Is this because of the more selecive beta-1 blockage of Metoprolol? or any other reasons?
Thank you any explanation.

MAIN REASON: as you said....metoprolol is more cardioselective (beta one)....hence more effective.

When there is beta one and beta two activity it may affect vessels initially and cause a reflex tachycardia....which is not so good for a weak heart! I hope that helps...

 

[cliffh65]

Thanks skapone33 and Shah_Patel_PT!

 

[Shah_Patel_PT]

Thanks skapone33 and Shah_Patel_PT!

No prob!

 

[48 hours]

This UW question is-
Which medication is the best choice for Antihypertensive therapy in in the patient with post-MI state. (the patient has no present complaints )

UW chooses Metoprolol instead of Propranolol.
Is this because of the more selecive beta-1 blockage of Metoprolol? or any other reasons?
Thank you any explanation.

yea, totally. This is just EBM at work. Propranolol wasn't in the study. And if the person also, had COPD or something, then you definitely want a beta 1 selective BB.

 

[Idiopathic]

atenolol and metoprolol are the two most studies beta-blockers and both are B1 selective (just to eliminate confounding/adverse SE due to B2 activity)

So, also remember your A-BEAM mnemonic (Atenolol, Betamaxolol [huh?], Esmolol, Acebutalol, Metoprolol)